NUR-550 Benchmark -Evidence-Based Practice Project: Literature Review

NUR-550 Benchmark -Evidence-Based Practice Project: Literature Review

Patient safety and improved quality of care requires providers and organization to use evidence-based practice (EBP) interventions to tackle issues that may cause adverse events like patient falls. Patients in medical-surgical units are susceptible to falls because of their delicate nature. The Centers for Medicare and Medicaid Services (CMS) considers falls as never events since they are preventable (Melnyk et al., 2022). Falls lead to increased stay in hospitals, poor patient outcome and serious fractures and head injuries that can lead to death. The use of bundled care approach through TIPS (tailoring interventions for patient safety) is considered one of the most effective ways to reduce and prevent falls in medical-surgical settings. The purpose of this literature review paper of the EBP project is to compare articles on the use of TIPS toolkit to reduce and prevent falls in medical-surgical settings.

PICOT Statement and Question

Nationwide, patient falls while in hospitals, particularly in medical-surgical units, are a leading cause of permanent disability and even death. Further, hospitalization increases one’s fall risk as close to three percent of patients fall while in hospitals. Nearly 30% of those who experience falls sustain injuries with a rise in the number of days in hospitals by close to 7 days. Again, under Medicare, the CMS does not reimburse falls and hospitals cannot get a Magnet designation when their fall rates are not below the national average (Khasnabish et al., 2020). The implication is that hospital managers and leaders must seek ways, through the use of evidence-based practice, to reduce the occurrence of falls. The use of TIPS toolkit is considered one of the most effective ways to reduce and mitigate falls and their occurrences as well as effects on patients in medical-surgical units.

PICOT Question

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 (O) within 6 months (T)?

Search Methods

The evidence-based practice process implores researchers to seek evidence from previous research articles when doing their literature to obtain findings that support their proposed projects or interventions. The use terms, phrases and words associated with the topic under investigation and exploring databases to generate scholarly sources are some of the standard search strategies that one can deploy to attain relevant evidence. The study employed these strategies, starting with key terms and words in different databases. These included PubMed, Cochrane and Google Scholar as well as CINAHL. The strategy also entailed the use of CRAAP approach that involves searching for articles which are current, relevant, accurate, authoritative and purposeful to the area or topic under investigations (Melnyk et al., 2022). Using this criteria, the paper identified the reviewed articles and describes how they support the proposed EBP project to reduce and prevent the occurrence of falls in medical-surgical settings.

Research Synthesis

Article 1

The first article by Dykes et al. (2020) evaluates the use of a patient-centered fall prevention TIPS to lower falls and their associated injuries. Using non-randomized controlled trials with the study set in 14 medical units in Boston and New York, the researchers show a positive link between the intervention and a decline in number of falls. The researchers are categorical that nurse-led interventions can reduce injurious falls through providing information to families on fall management and prevention. The article demonstrates the efficacy of using TIPS as an intervention as depicted by the PICOT question.

Article 2

The second article by Tzeng et al. (2021) focuses on the impact of using TIPS program in reducing falls among older adults in nursing homes. Using a mixed method approach in a 15-bed nursing unit, the findings from the study shows that fall TIPS can reduce the rate of falls, especially injurious falls among older patients or adults. The TIPS program entails different approaches that include patient education and creating awareness about the harmful effects of falls. The article is critical to the EBP proposed project as it illustrates the increased role of TIPS initiative to reduce falls as depicted in the PICOT question. The article supports the EBP project since it shows that TIPS as an intervention is effective.

Article 3

In this article by Morris et al. (2022) the researchers conduct a systematic review of literature and meta-analysis on diverse interventions that can reduce falls. The researchers identify a host of interventions based on the da