NR 439 Week 2 Discussion: Research, Practice Problems, and Questions (graded)

Nursing roles in ensuring that patients get satisfactory, efficient, and sufficient patient services are vital in healthcare settings. However, various nursing clinical issues have arisen in the past, at present, and may occur in the future. While some of the nursing clinical issues have effectively been sorted and managed on different scales, some continue to be a challenge, hence threatening the fundamental goal of offering patients the best healthcare services for improved patient outcomes. One of such issues that have been a challenge and continue to be a challenge is patient falls. Inpatient hospital falls occur in various admission wards and is associated with numerous adverse effects on the health of patients as well as the hospital’s reputation.

Description of The Problem

Inpatient hospital fall can be regarded as any event that leads to a patient finding himself/herself in the fall during the hospital stay. The fall can take the form of unintentional or unplanned taking of the patient to the ground, whether assisted or unassisted. An unassisted fall happens in the event that a patient is alone and falls in the absence of another person to witness and help the patient (Heng et al., 2020). On the other hand, assisted fall occurs when a staff member is present and eases the patient to the ground. In one of the recent studies conducted in the US, patients have a chance of twelve percent of falling whenever admitted into a healthcare facility. The rates of patient falls differ widely from hospital to hospital globally, with the range falling between three to eleven fall per every one thousand bed days. In all the patient fall events, close to twenty-five percent of the falls result in soft tissue injuries and fractures.

Effects and Common Causes of Patient Falls

Patient falls can have detrimental effects on the patient’s health, and especially on the health of older adults who are always at more risk of falling than fairly younger patients. Some of the effects of patient falls include both economic and physical burdens. When a patient falls, there get injured, mortality rates rise, and the quality of life is substantially decreased. Besides, inpatient falls lead to a higher length of hospital stay and higher medical costs (LeLaurin & Shorr, 2019). Inpatient falls can also lead to litigation as some patients, and their family members may have an opinion that the fall is the hospital’s fall. The cause of patient falls has been associated with several factors, For instance, medications administered to patients, muscle weakness, polypharmacy, pain, anesthetics, co-morbidities, and ill-health.

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Due to the several negative effects of inpatient falls, various stakeholders such as healthcare facilities, researchers, healthcare professionals, and others have come up with various efforts to try and minimize the incidences of patient falls. Besides, most of the hospitals have puts in place different guidelines for preventing patient falls such identification of those patients at high falling risk, so that appropriate step is taken (LeLaurin & Shorr, 2019). The other method is applying clinical judgment to choose the best fall prevention strategies to use.

PICOT Question

The issue of inpatient falls important to me and worthy of looking at evidence about it. The use of an answerable clinical question is vital in getting the evidence needed to solve a clinical issue. Therefore, this research will look at the efficacy of using bed alarms to control patients. Among the patients admitted to the neurosurgery unit (P), what is the influence of using bed alarms (I) compared to communication (C) in reducing patient fall rates (O) after twelve months (T)

Conclusion

Many adverse effects of inpatient falls dictate that inventive and innovative strategies are applied in managing it. It is important to a literature search and identifies various strategies that have been applied for the same. Evaluation of the best strategy requires an answerable clinical question in a PICOT format

References

Heng, H., Jazayeri, D., Shaw, L., Kiegaldie, D., Hill, A. M., & Morris, M. E. (2020). Hospital falls prevention with patient education: a scoping review. BMC geriatrics, 20, 1-12. Doi: 10.1186/s12877-020-01515-w

LeLaurin, J. H., & Shorr, R. I. (2019). Preventing falls in hospitalized patients: state of the science. Clinics in geriatric medicine, 35(2), 273. Doi: 10.1016/j.cger.2019.01.007Links to an external site.

Catheter-associated urinary tract infections (CAUTIs) are the most prevalent hospital-associated infections. It accounts more than 30% of acute care hospital infection. More than 13,000 deaths are associated with Healthcare-associated infections each year. CAUTIs compromise patients’ condition, cause complications, and prolong patients’ ICU stay. CAUTIs could lead to sepsis and death. CAUTIs are one of the challenges to quality care in the ICU unit where I work.

My PIOCT question:

Among critically ill patients in ICU (P), will using alternative methods and strategies before placing the urinary catheters (I), reduce CAUTIs during hospital stay (O), compare to use indwelling catheter only (C), over a three-month period (T)?

My PIOCT elements are as following:

P: critically ill patients

I: use alternative methods and strategies before placing the indwelling catheter

C: use indwelling catheter only

O: reduce CAUTIs in ICU

T: over a three-months period

ICU patients have the highest risk of developing hospital-associated infection. They are usually severely ill and extremely vulnerable to experience adverse outcomes. CAUTIs are one of the major threats to ICU patients’ safety. More than 500,000 patients develop CAUTIs each year, leading to extended hospital stays, increasing patient morbidity and mortality. CAUTIs costs millions of dollars of healthcare. The Joint Commission has been addressing the goal of implementing evidence-based practices to reducing the healthcare-associated infection related to CAUTIs. CAUTI is preventable. Reducing CAUTIs is RNs’ priority. RNs are obligate to lead this action, use evidence-based practice, reduce CAUTIs, prevent harm and save life.

reference:

ANA CAUTI Prevention Tool

https://www.nursingworld.org/practice-policy/work-environment/health-safety/infection-prevention/ana-cauti-prevention-tool/Links to an external site.

Podkovik, S., Toor, H., …… & Wang, S. (2019). Prevalence of catheter-associated urinary tract infections in neurosurgical intensive care patients – the overdiagnosis of urinary tract infections.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6816532/#:~:text=CAUTIs%20can%20lead%20to%20more,(UTIs)%20%5B2%5DLinks to an external site..

Woten, M., & Mennella, H. (2018). National patient safety goals (The Joint Commission, 2018): Selecting evidence-based measures to monitor catheter-associated urinary tract infections (CAUTIs).

https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=nup&AN=T903601&site=eds-live&scope=siteLinks to an external site.

Woten, M. & Mennella, H. (2018). National patient safety goals (The Joint Commission, 2018): Monitoring compliance with evidence-based practices to prevent catheter-associated urinary tract infections.

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Woten, M. & Mennella, H. (2019). National safety goals 2019: Goal 7E. Limiting use and duration of indwelling urinary catheters (NPSG.07.06.01).

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Week 2 Discussion: Research, Practice Problems, and Questions (graded)

Your topic is the one that many healthcare workers are continually working on every single day! Patient falls is a major and serious public health problem.

Patient falls during hospital stay are among the most common incidents reported in the hospitals in U.S. and worldwide. There are 700,000-1,000,000 patients falls each year in U.S. According to The Joint Commission, 30-50% of falls result in an injury. Falls prolong patients’ hospital stay and could lead to secondary complications. Falls also increase healthcare cost. Patient falls is an obstacle for achieving quality and safety of patient care.

Reference:

A complimentary publication of The Joint Commission Issue 55, (2015). Preventing falls and fall-related injuries in health care facilities.https://www.jointcommission.org/-/media/deprecated-unorganized/imported-assets/tjc/system-folders/topics-library/sea_55pdf.pdf?db=web&hash=53EE3CDCBD00C29C89B781C4F4CFA1D7Links to an external site.