The main aim of this research proposal is to show that the clinical question warrants investigation. The clinical question asks whether toileting patients every hour reduce the incident of falls. Included in the paper are PICO question and evidence proposal. The paper uses Johns Hopkins Nursing EBP Model and Guidelines.
Change model overview
John Hopkins Nursing Evidence-Based Practice Process is an approach used to solve problems related to decision making, and it contains tools that give guidance to users. John Hopkins Nursing Evidence-based practice model involves the PET process which includes practice question, evidence, and translation. Application of the PET process includes identification of a practical question, collecting evidence through literature review and finally coming up with recommendations on how to translate research results into best practices. Nurses should use John Hopkins Nursing Evidence-Based Practice Process to enable fast and appropriate inclusion of the latest study result and best practices when caring for patients.
Practice question
Step1: Recruit inter-professional team
Several members will be included in the project with me as the team leader. Relevant stakeholders who will be involved in the project include pharmacists, charge nurses, and social workers. Other stakeholders who will be incorporated in the project team are nursing assistants, physical therapists, and health educators.
Step 2: develop and refine the EBP question
The clinic issue that will be under study is: do toileting patients every hour reduce the incident of falls? PICO elements involve the problem, intervention, comparison, and outcome. The problem in the clinical question includes an event of falls while intervention includes toileting patients every hour. The comparison involves the alternative that can be compared with the intervention which includes keeping a safe environment in hospitals for all patients. Placing items that may be required by patients within their reach and keeping beds in low position are also comparisons of the clinical questions. The outcome in the EBP question includes reducing the incident of falls.
Step 3: Define the scope of the EBP
The problem of the clinical question includes an incident of falls. An incident of falls is a problem since it leads to sustained injuries. An incident of falls is also an issue since it not only leads to physical constraints, but it also has some financial effects. Approximately 63% of falls in hospitals lead to death while about 30% sustain severe injuries. Falling related injuries result in a given percentage of re-hospitalization after patient discharge which will in turn cause accumulation of healthcare costs. Injury deaths mostly in adults older than 65 years come as a result of patient falls. An incident of falls impact healthcare on a broader scale since falling is a safety threat to patients within hospitals. Injuries that can be sustained as a result of falls include severe fractures and uncontrollable bleeding. Serious injuries can lead to surgical repair which will result in increased healthcare costs.
Step 4 and 5: Determine Responsibility of Team members
Members chosen for the project perform several responsibilities. Project members are important since they carry out necessary research and analyze required data to obtain results. Health educators are responsible for educating patients and families on how to reduce the incident of falls. Social workers carry out research on how to keep floors clear of mess and equipment that may lead to falls. Nursing assistants are assigned the responsibility of conducting research on fall prevention practices while the pharmacists collect data on how to manage patients after fall. The responsibility of charge nurses includes ensuring safety delivery of healthcare for patients.
Evidence
Step 6 and 7: Conduct internal/external search for evidence and appraisal of evidence
Peer reviewed evidence was found using four reliable sources. Evidence-based practice guidelines were used to carry out research. Qualitative research was conducted, and quality improvement data was collected. The strength of the study is that it provides the latest results and best practices that can be taken into consideration when caring for patients.
Step 8 and 9: Summarize the evidence
Patient falling in hospitals can be as a result of impaired balance, altered mobility, visual impairment or dizziness. According to research, patient falling in hospitals is contributed by complex activities, circumstances, and features. Toileting patients every hour reduces falling incidents that can come as a result of wet floors from urine spills in patient rooms. The event of falls can not only be reduced by toileting students every hour but also through keeping lights on at night and observing personal hygiene. As indicated in, safer walking technology should be provided in hospitals to reduce patients falling incidents. Toileting patients every hour is an example of ethical issues that should be practiced by nurses to reduce injuries caused by patient falling. Building a safe clinical environment reduces patient falls thus cutting on possible costs as a result of severe injury treatment.
Step 10: Develop recommendations for change based on evidence
There are several recommendations based on the research. More accurate instruments should be developed in hospitals to enable assessment of patient falling risks. Apart from toileting patients every hour, nurses should be educated on other safety measures such as removing excess equipment and cleaning spills to reduce patient falling. Exercise programs should be introduced in hospitals to strengthen weak legs. Additionally, a safe environment should be maintained for all patients in hospitals to reduce the incident of falls.
Translation
Steps 11, 12 and 13, 14: Action plan
Implementation of the pilot study will include several steps. The study will be on whether toileting patients every hour reduce the incident of falls. The study will begin by selection of project members. The selected project team will then be assigned several responsibilities and a timeline for role completion will be given. The methodology that will be used to carry out research includes interviewing and issuing questionnaires. Several clinics will be visited, and data collected using interviews and questionnaires. Outcomes of the study from a sample of hospitals will finally be analyzed, and findings reported using a diagram to enable quick understanding of the results.
Step 15 and 16: Evaluating outcome and reporting outcomes
The desired outcomes include a high percentage of patient falls in clinics every month and reduced falls as a result of toileting patients every hour. Results are also expected to indicate other alternative actions that can be applied in hospitals to reduce the incident of falls. Results will be measured using the qualitative method. Results will then be reported to key stakeholders using a table and in text form.
Step 17: Identify next steps
Same steps with a larger sample with be used to implement the plan on a larger scale. A Larger sample will apply to the facility as a whole. Giving logical and relevant recommendations will ensure implementation becomes permanent.
Step 18: Disseminate Findings
Findings will be communicated internally through sending regular updates through emails, posters, and internal memos. External communications will be done through adverts and journals.
Conclusion
Incidents of falls in hospitals may be reduced through toileting patients every hour. Severe injuries as a result of patient falls will not only extend the hospital stay, but it can also lead to discharge to a rehabilitation faculty. The key aspects of the problem include the practical question, evidence, and translation. The clinical question on whether toileting patients every hour reduce patient falls has been interpreted regarding the problem, intervention, comparison, and outcomes.
References
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Pantzartzis, E., F. Price, A. D., & Pascale, F. (2016). A built environment response to the rising costs of dementia. Journal of Financial Management of Property and Construction, 1-20.
