Grand Canyon University
Falls is a leading cause of injury in the acute hospital setting and the development of evidenced based practice to lower the incidence of falls is imperative. Falls can cause injuries that range from minor to major and can cause complex issues for the patient. Falls can occur to any patient in the hospital setting, however, falls generally affect the geriatric patients because they occur due to factors such as poor vision, muscular weakness, chronic illnesses, dementia, and imbalance problems. Additionally, younger patients can sustain falls because of the injuries or illnesses they suffer as well as the sedation and pain medications that are utilized in the hospital. With all this to consider falls are a significant problem in the hospital and the development of a fall prevention measure is imperative. The author developed a plan to decrease the incidence of falls by utilizing hourly rounding and fall risk assessment tools in the acute hospital setting. This paper will evaluate evidenced based practice articles on hourly rounding and fall risk assessment tools and the ability to decrease the incidence of falls.
Comparison of research questions
The research questions associated with the issue of falls are inclined to emphasize the use of hourly rounding and assessment tools to decrease the number of falls. The PICOT statement made by the author is how hourly round and the use of assessment tools decreases fall in the hospital setting. Each article evaluated is similar but uses different fall assessment models and hourly rounding procedures. An et al., (2017), researched a specific assessment tool in the evaluation of patients at high risk for falls and the ability to utilize the assessment tool to decrease falls. Dyck et al., (2013), researched the use of an hourly rounding concept in the incidence of high risk fall patient and the ability of the hourly rounding process to decrease the number of falls. Hick, D. (2015), utilized the concept of hourly rounding and the incidence of falls and how hourly rounding decreases the number falls in high risk patients. This article research how rounding very hour compared to every other hour increases or decreases the number of falls. Cournan, M., Fusco-Gessick, B., & Wright, L., (2018), researched the use of video monitoring a concept of hourly rounding and the relation in the reduction of falls, additionally, how this specific intervention can be implemented in patient at high risk of injury related to falls. Fusco-Gessick, B., & Cournan, M., (2018) and Kaplan et al., (2019), researched the concept of a fall risk assessment tool and the relation with falls and high risk patients that are evaluated appropriately. Each of the studies researched a specific assessment tool and the use of the assessment tool and evaluation of patient at high risk, additionally, how the assessment tools relate in decease incidences of falls. Overall, all six studies researched either hourly rounding or fall risk assessments and the decreased incidence of falls.
Comparison of sample populations
Most of the articles had large population setting and most focused in the elderly populations. Dyck et al., (2013), and Hick, D. (2015), utilized the research in an inpatient setting at an acute hospital. They both focused on patient at high risk, but specifically the elderly population. An et al., (2017), utilized a inpatient stroke unit as the sample population, more specifically they used an inpatient 20 bed stroke unit and evaluated stroke patient who were at high risk for falls. Cournan, M., Fusco-Gessick, B., & Wright, L., (2018), utilized 15 video monitoring systems at monitoring high risk patients for falls. Fusco-Gessick, B., & Cournan, M., (2018), and Kaplan et al., (2019), both evaluated patient in the rehabilitation setting and evaluated patients who were at high risk for falls.
Comparison of limitations of the study
There are similar limitation of the chosen articles and studies that researched the use of hourly rounding and assessment tools in relation to decreased patient falls. The limitations were mostly associated with sample size, data collection methods and data that was self-reported. Additionally, insufficient preceding research or studies pertaining to evidenced based solutions and prevention strategies in the prevention of falls. An et al., (2017), and Cournan, M., Fusco-Gessick, B., & Wright, L., (2018), specifically used smalled sample studies and the results were limited because of the small sample sizes. Research needs to be done with larger sample sizes to void more effective results. All six articles used appropriately methods to gather data, thus the results obtained through the method were used to gather sufficient data to lead to direct conclusions. Overall, there were several limitations to the articles, however, all six articles had sufficient data on the decreased incidence of falls with the utilization of hourly rounding and fall risk assessment.
Literature review supports the authors PICOT in the prevention of patient falls in relation to using hourly rounding and fall risk assessment tools. Reviewing the literature have allowed the author to research the importance of hourly rounding and fall risk assessment in the relation with decreased incidence of falls. All studies used appropriate sample sizes, settings and methods that gave appropriate data for the author to develop a plan to decrease patient falls. Overall, the literature review paved the way for the author to continue to develop a specific plan at using hourly round and fall risk assessment in decreasing the incidence of falls.
An, S. H., Jee, Y. J., Shin, H. H., & Lee, G. C. (2017). Validity of the original and short versions
of the dynamic gait index in predicting falls in stroke survivors.
Cournan, M., Fusco-Gessick, B., & Wright, L. (2018). Improving patient safety through video
Dyck, D., Thiele, T., Kebicz, R., Klassen, M., & Erenberg, C. (2013). Hourly rounding for falls
prevention: A change in initiative.
Fusco-Gessick, B., & Cournan, M. (2018). Using functional independence measure subscales to
predict falls rapid assessment.
Hicks, D. (2015). Can rounding reduce patient falls in acute care?
Kaplan, S. E., Cournan, M., Gates, J., Thorne, M., Jones, A., Ponce, T., & Rosario, E. R. (2019).
Validation of the casa colina fall risk assessment scale in predicting falls in inpatient
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NRS 490 Literature Evaluation Table PICOT Statement.docx