Answer

Current Clinical Practice Guidelines on Patient Falls

The scope of this document is rather wide revolves around clinical practice guidelines on patient falls in the modern word. In fact, the document’s purpose involves review and documentation of existing evidence base with regard to interventions to prevent patient falls in hospitals. In addition, the document goes ahead to present an overview of the performance of existing tool with known measurement as well as compiled available resources. As such, the document’s purpose is to provide its readers with proper and working guidelines regarding hospital fall prevention (Hempel et al., 2012). Indeed, the document comes across as a resource guide on the best existing clinical practices on patient fall prevention. This is in recognition to the fact that several resource guides on reduction and prevention of falls in hospital exists, but with varying levels of success. In sum, the document’s purpose is to bridge the divide through systematic review as well as documentation of existing and practical evidence base for fall prevention in hospitals.

            Stakeholder involvement in the document includes RAND (Research and Development), which is a renowned American corporation specializing in research and develops solutions to public policy problems to assist in making global communities safer, healthier, as well as secure. It is a not-for- profit organization meaning that it is nonpartisan and remains committed to the public interest. Nevertheless, the document’s review was carried out by RAND’s Southern California Evidence- based Practice Center (EPC) using their principles to generate a concise as well as structured synopsis of falls prevention tools, interventions, and other resources. The other stakeholder is AHRQ (Agency for Healthcare Research and Quality). As a stakeholder, AHRQ is concerned with producing the document’s findings to make health care safer as well as make it of higher quality (AHRQ, 2016). In addition, this stakeholder works within the American Department of Health and Human Services as well as with various partners to ensure that the evidence is comprehended and applied (Sorra, & Dyer, 2010). Altogether, the interventions, tools, as well as existing resources identified in the documents are meant to be integrated into the AHRQ toolkit regarding fall prevention in hospitals. The target population is without a doubt practitioners and clinicians in United States environment. Notably, the term practitioner is rather broad and may include nurses and doctors. This target population is mostly concerned with patient care in hospital care, and the document seeks to provide them with a large number of intervention evaluations out of which they can base their decisions. In fact, this target population is expected to adopt the document as their blueprint on matters concerning fall prevention in hospitals.

            The development of this document is quite rigorous as evidenced through the considerable research put into it. In fact, the development of the document sees the research efforts refer to evidence from existing studies on fall prevention identifying intervention components used around the world and corresponding outcomes. Doing so requires considerable effort on researcher’s part and, in all likelihood, leads to the development of a detailed document that the target population can adopt. The document’s purpose is to review existing evidence on fall prevention and document it, and thus does a plausible job by presenting evidence-based information on studies around the world including reported outcomes. This is vital to the development of the document simply because it makes it increasingly believable and practitioners can read what intervention components were used and corresponding outcomes. Indeed, some of the systematic techniques used in developing the guideline include identifying reviews describing hospital pertinent interventions through searching DARE (Database of Abstracts of Reviews of Effects), Cochrane Database of Systematic Reviews, and pubmed utilizing a systematic review filter as well as personal files. What is more, existing falls prevention toolkits as well as guidelines were screened. This led to the identification of primary studies reinforced via searching databases as well as the Web of Science for recent publications that are yet to be captured through current comprehensive hospital fall prevention guidelines or reviews. However, the outlined search strategy is not necessarily restricted to a set of known interventions (Boltz et al, 2012). As such, it is kept broad so as to allow identification of diverse approaches.

            Recommendations in the document include the need for practitioners to evaluate carefully if interventions are applicable in the United States setting. The manner in which the document is development means that information presented is broad and does not specifically mean that it is applicable for all hospital environments. In fact, each country has its own regulations and interventions components often abide to such regulations. Nevertheless, only about 11 control studies in the document evaluated fall prevention interventions in the United States setting with the rest coming from the international arena. For this reason, it is recommended that practitioners evaluate carefully if shown interventions fit the United States setting. In fact, practitioners ought to be aware that variations exist across the spectrum as some studies presented in the document utilized fall risk evaluation scales to select patients and assigned only high-risk patients to the intervention as well as the control group. Nonetheless, in clinical practice individual hospitals will need to address the issue by balancing the desire to implement fall prevention strategies with the imperative need to conserve resource. It is recommended that practitioners carefully evaluate which intervention components presented in the document are appropriate as well as likely to be cost-effective for individual or local situation. As well, practitioners are advised that selected approaches may be required to vary across hospital wards. Altogether, recommendations are clearly presented revealing information that though the document is to serve as the blueprint for practitioners on fall prevention matters, caution ought to be exercised. In fact, the recommendations signify that the document must not be taken to fit all hospital setting and the need to localize fall prevention components in hospitals is paramount.

            As far as application is concerned, the document cites the multi-component as well as context-specific nature of identified interventions as a barrier. In fact, it is challenging to recommend specific intervention (s) or to establish the components that must be present for intervention components to be deemed successful. It follows that the outcomes associated with information on the guideline cannot always be guaranteed. In addition, cost emerges as a hindrance because of the pertinent need to balance resources and meet corporate or commercial success (Schoene et al, 2013). Monitoring criteria largely involves reduction in the number of patient falls in hospital settings, which again signifies that the intervention components presented, need to be localized to fit the setting if the numbers are to be kept at a minimum. Often, the outcome is that no intervention component lead to complete elimination of patient falls.

            Editorial independence in the document is evidenced through the inclusion of nonpartisan stakeholders such as RAND. In fact, this organization minimizes the risk of conflict of interest because it translates to presentation of non-biased information as far as research process is concerned. In fact, the nonpartisan stakeholders mean that information is not cooked up via use of selective studies as information sources. More so, the involvement of nonpartisan bodies in the development of the document means that it is likely free from influence from such groups as government, who mostly seek to determine study outcomes during funding (Fabre et al, 2010).

            The document identifies a number of intervention evaluations, current tools with known measurement characteristics, as well as published resources. The aim is to present practitioners with an exhaustive list of clinical practices on fall prevention around the world. Indeed, caution is recommended as practitioners need to ensure that adopted intervention component fits the specific hospital setting. In essence, fall prevention in hospital setting ought to consider specific dynamics that practitioners may identify through proper screening of individual patient. This means that clinical practice guidelines need to be viewed as structure through which practitioners work. Thus, the student will apply the clinical practice guidelines in practice by screening a patient and adopting the listed guidelines to fit the specific case. For instance, hospital and local government regulations regarding proper care must be observed including use of proper or recommended restraints. In sum, the various considerations must be made to ensure that the issue of patient falls is dealt with wholly.