Patient falls in inpatient settings
In this paper, the contribution of the findings of the current study to the existing literature on evidence-based practices will be discussed. The study design to be used for the study will also be identified and its choice justified.
Contribution to evidence-based practices literature
There are characteristic knowledge gaps in current literature on patient falls, factors contributing to inpatient falls, falls preventions strategies and their utilization. In relation to this study, a myriad of studies that have led to the development of numerous fall prevention strategies have been conducted. Majority of the strategies developed so far are complex and multi-faceted. They incorporate behavioral and environmental components such as introduction of fall risk assessment tools, educational strategies targeted at health care practitioners, patients and their relatives, promotion of a culture of organizational safety, regular medication reviews amongst others (Pearson & Coburn, 2011). Empirical evidence indicates that these interventions are not being utilized. Despite these though, only a few studies have explored the factors that prevent implementation of these fall prevention strategies by nurses (Pearson & Coburn, 2011).
On the other hand, studies that have examined the contribution of organizational system characteristics to patient falls have reported mixed findings. The organizational system factors that have been extensively documented as influencing patient falls include the knowledge of nursing staffs, nurse staffing ratios, and organizational culture. A study by Lopez et al. (2010) that aimed at identifying nursing factors within the domain if nursing that contribute to patient falls is one of the studies that have reported contrary findings. In this study, these factors were found to be of little significance. Nursing work processes were however found to underlie patient falls. The studies that have explored the relationship between nurse staffing ratios and incidence of patient falls have also reported mixed findings.
Therefore, although there is a plethora of information on fall prevention strategies and interventions, there is paucity in literature because very few studies have explored the factors that hinder or promote nurses utilization and implementation of fall prevention measures. Additionally, many of these fall intervention programs were tailored to meet the needs of specific hospitals and long-term care facilities (Hughes, 2008). Their compatibility with the system factors of all hospitals or nursing homes is thus uncertain. The findings of this study will therefore help to bridge the existing gaps in knowledge. This is because it will facilitate the identification of nurse and system-related factors that prevent the utilization of evidence-based fall prevention strategies. The replication of the findings of other similar studies by this particular study will, on the other hand, enhance the strength of such findings. This is because the strength of evidence of the findings of clinical studies depends on the number of times the findings are replicated in identical studies.
Research design
This study will adopt a qualitative study design. The selection of this design was guided by the purpose of the study: to explore nursing staff and organizational characteristics that prevent nurses from utilizing or implementing fall prevention measures for elderly patients at risk. Qualitative data will be collected from the study participants. It will then be subjected to qualitative thematic analysis. Qualitative content analysis is a research method that allows subjective interpretation of data through the systematic categorization process of coding and identification of emerging themes or patterns (Hsieh & Shannon, 2005, p. 1278). It is a flexible method of analyzing the content of textual data. It is employed in studies like this one, where a gap or paucity in research literature exists (Kondracki & Wellman, 2002). This research method avoids the creation of preconceived clusters allowing instead, categories and category names to emerge from the data contents hence it is appropriate for the study (Hsieh & Shannon, 2005).
Conclusion
In conclusion, the findings of this study will help bridge the current gap in knowledge particularly on the factors that hinder the utilization by nurses of fall preventive measures for elderly patients at risk. It will also strengthen the knowledge base of existing literature particularly in regard to pertinent areas where current evidence is inconsistent. A qualitative design will be adopted for this study.
References
Currie, L. (2008). Fall and injury prevention. In R.G. Hughes (Eds.), Patient safety and quality:
An evidence-based handbook for nurses. Rockville (MD): Agency for Healthcare
Research and Quality.
Hsieh, H.F., & Shannon, S.E. (2005). Three approaches to qualitative content analysis.
Qualitative health research, 15(9), 1277-1288.
Lopez, K. D., Gerling, G. J., Cary, M. P., & Kanak, M. F. (2009). Cognitive work analysis to
evaluate the problem of patient falls in an inpatient setting. J Am Med Inform Assoc.,
17(3), 313-321.
Pearson, K. B., & Coburn, A. F. (2011). Evidence-based falls prevention in critical access
hospitals. Retrieved from http://flexmonitoring.org/documents/PolicyBrief24_Falls-
Prevention.pdf.
