Identifying & Implementing EBP
Create an initial proposal based on a problem you have witnessed firsthand at a healthcare facility or one that you feel should be addressed.
Identify the problem and provide a summary of why this topic is a good candidate for Evidence-based practice (EBP).
Patient fall in Wards
Patient falls a major problem in the inpatient department that affects almost all hospital facilities. It is the unintentional and unplanned descent of patients, which can result in small and acute injuries (Singh, Okeke, and Edwards, 2015). Varieties of factors have contributed to the fall of patients in the inpatient department. One of those is that of the age of patients. Specifically, patients of 65 years and above are bound to fall because of the weaknesses of their bodies and bones as well as their inability to walk. Additionally, Ward-Smith et al. (2014) opine that falls arise from wet floors in the department. Moreover, patients fall as they try to move from their beds to the washrooms. Others would experience a fall as they seek to pose good and comfortable sleeping postures (Ward-Smith et al., 2014). Falls are also attributed to the existence of patients with chronic diseases and seizures as well as those experiencing disorientation and confusion. Lack of effective interventions to fall prevention in health care facilities has been attributed to the problems of costs related to hospitalizations as well as legal fees for the patients who claim neglect (Miake-Lye et al., 2013). As such, hospitals must deploy effective methods of preventing falls.
One of the most common interventions to falls is the deployment of hourly rounding. In this case, Flimban et al. (2016) state that the nurses deploy a standardized hourly rounding program, which ensures that the needs of the patients in the inpatient department are met. The program involving nurses assessing the patients’ needs after every hour. Other interventions have been deployed such as bedside reporting and the use of emergency bells, which alert the nurses. However, according to Miake-Lye et al. (2013), these other interventions have been termed as ineffective as bedside alarms may not be useful when the patient cannot be able to tap them before they fall. Specifically, bedside reporting does not prevent but rather is useful only when the fall incidences have already occurred (Goldsack et al., 2015). For this reason, hourly rounding has been preferred due to its ability to make short visits to the patients and ensure that they are comfortable and safe from any danger of falling.
In conclusion, the capstone project will be based on the importance of hourly rounding in the reduction of the rates of patient falls in the inpatient department of hospitals. The problem of patient falls affects the safety of the patients especially those suffering from chronic illnesses and confusion. The importance of this problem is that it leads to the use of the most appropriate intervention. It affects nursing, as its intervention, which is hourly rounding, requires the services of the nurses who have to make regular visits to the wards and assess the needs of each patient. This capstone project will therefore argue a case for hourly rounding as an evidence-based practice for the reduction of patient calls compared to other interventions such as bedside reporting.
Brosey, L. A., & March, K. S. (2015). Effectiveness of structured hourly nurse rounding on patient satisfaction and clinical outcomes. Journal of nursing care quality, 30(2), 153-159.
Flimban, M. A., Abduljabar, D. F., Dhafar, K. O., Deiab, B. A., Gazzaz, Z. J., Bansuan, A. U., … &Suliman, M. I. (2016). Analysis of patient falls among hospitalised patients in Makkah region. JPMA. The Journal of the Pakistan Medical Association, 66(8), 994.
Goldsack, J., Bergey, M., Mascioli, S., & Cunningham, J. (2015). Hourly rounding and patient falls: what factors boost success?.Nursing2015, 45(2), 25-30.
Hayakawa, T., Hashimoto, S., Kanda, H., Hirano, N., Kurihara, Y., Kawashima, T., & Fukushima, T. (2014). Risk factors of falls in inpatients and their practical use in identifying high-risk persons at admission: Fukushima Medical University Hospital cohort study. BMJ open, 4(8), e005385.