Among hospitalized adult patients in medical-surgical units (P) does the use of TIPS toolkit as a bundled care approach (I) compared to normal falls prevention approach (C) reduce the prevalence of falls by 20%(O) within 6 months (T)?

Among hospitalized adult patients in medical-surgical units (P) does the use of TIPS toolkit as a bundled care approach (I) compared to normal falls prevention approach (C) reduce the prevalence of falls by 20%(O) within 6 months (T)?

Organizational culture which entails values, mission, vision and operational efficiencies is important on implementing or introducing changes to nursing units or workplace. The implementation of EBP project proposal to reduce falls through Fall TIPS approach requires organizations to have a change-oriented culture and values. Evaluation is essential as it allows project team to determine the level of readiness and acceptance of change. In this case, the organizational structure in the medical-surgical unit is positive. The findings from the Organizational Capacity Assessment Tool (OCAT) created by the United Nations Development Program (UNDP) shows that the unit has decentralized structure that allows engagement and participation of nurses to implement changes to improve the quality of patient care (Ratnapalan, 2019.

The OCAT tool assesses  overall readiness and highlights organizational capacities and strengths. Based on the model, the overall organizational culture and readiness for change is positive since the unit as part of the entire facility has capacities and strengths. These include having effective teamwork to improve communication, integration of providers’ perspectives when implementing new approaches to care, and better communication and effective collaboration among the internal stakeholders. Data analysis tools are also essential to improving overall efficacy of the proposed solution (DeNisco, 2019). The organizational culture also focuses on health promotion and saving lives through involvement of all stakeholders at different levels of care delivery.

Falls are a major concern and public health issue because they affect quality of care and patient safety. The Centers for Disease Control and Prevention (CDC) (2021) observes that one in every four older people experiences falls. Close to 800,000 individuals are hospitalized each year due to falls, especially in critical care settings. more than 95% of hip fracture occur due to falls and falls are the most prevalent cause of traumatic brain injuries (Heng et al., 2020). The Centers for Medicare and Medicaid Services (CMS) categorize falls as never events since a majority of them are preventable. Falls also increase hospital stays and increase cost of care. Therefore, reducing falls is a critical part of improving patient safety ad overall care delivery (PSNet, 2019). Existing literature supports the use of Fall TIPS as an EBP intervention to reduce and prevent falls.

The proposed interventions should be appropriate through a review of existing literature consisting of previous research studies to support implementation and expected benefits to the targeted population. In this case, through a comprehensive search of the literature, one can ascertain if the interventions meets the stakeholders’ goals and aspirations (Zhao et al., 2018). The literature review for the project involved the definition and use of terms associated with Fall TIPS and its benefits for patients, especially in medical-surgical settings. The review also employed appropriate search engines and databases associated with the nursing issue to ensure that the generated articles focus on the problem under investigation (Khan et al., 2018). The main inclusion criteria included article published within the last five years, articles that capture aspects of the PICOT question and focus on effective interventions to reduce falls and efficacy of Fall TIPS implementation.

The proposed project reviewed several research studies based on the inclusion and exclusion criteria to ascertain support for the intervention to enhance patient safety and quality of care through fall prevention using the Fall TIPS model. Literature synthesis and critical analysis show increased support for the intervention of using Fall TIPS model to reduce falls. Studies by LeLaurin et al. (2019); Xia et al. (2022); Kelly (2022), and Dykes et al. (2020) agree that fall prevention bundles through the TIPS model reduce incidences of falls and improve overall patent safety. The studies show that Fall TIPS is effective and should be implemented on diverse settings that include medical-surgical units because of their benefits like being customized to meet patient needs and situations. The studies also emphasize the need for effective guideline for providers to enhance their adoption of fall TIPS in their practice settings.

The selected model is the Iowa EBP framework. The Iowa model focuses on the entire healthcare system and stakeholders who comprise of patients, practitioners, and infrastructure. The framework uses a problem-solving and implores staff to question the current nursing practices and if they can improve care through using current evidence. The model is effective for the project as it focuses on promoting quality care using EBP interventions (DeNisco, 2019). The initial stage of the model is identification and selection o