Describe a clinical situation where you were concerned (e.g., a higher incidence of falls, infections, errors, etc.) and where decisions were made to improve the situation. What sources of evidence were utilized to make the decision (e.g., personal experience, expert advice, etc.)? I need one full page with two references to support the evidence.
Title: Utilizing Evidence-based Practices to Address the High Incidence of Falls in a Clinical Setting
Introduction:
Within the clinical setting, healthcare professionals are continuously faced with various challenges that may compromise patient safety and quality of care. One common concern encountered is an increased incidence of falls among patients, which can have significant negative consequences on their well-being. This paper aims to discuss a clinical situation where a higher incidence of falls was observed and the decisions made to improve the situation. Additionally, it will explore the sources of evidence utilized to inform these decisions.
Clinical Situation: Higher Incidence of Falls
In a medical-surgical unit of a tertiary care hospital, the nursing staff had noticed a concerning increase in the number of fall-related incidents over a six-month period. Falls not only pose physical risks for patients but also lead to increased healthcare costs, longer hospital stays, and reduced patient satisfaction. Identifying the underlying causes of these falls and implementing appropriate interventions was crucial to improve patient safety.
Evidence-based Decision-making:
To address the high incidence of falls, the healthcare team adopted an evidence-based approach in making decisions. Evidence-based practice (EBP) involves integrating the best available research evidence with clinical expertise and patient preferences to guide decision-making (Sackett et al., 1996). The team utilized various sources of evidence to inform their decisions, as outlined below.
1. Research Evidence:
The team extensively reviewed published research literature related to fall prevention strategies and interventions. They searched and critically appraised studies using a systematic approach to identify those with robust methodologies and solid evidence base. Studies that provided insight into causative factors, risk assessment tools, and effective fall prevention interventions were given priority. This approach ensured that the decisions made were grounded in the best available scientific evidence (Melnyk & Fineout-Overholt, 2019).
Key findings from the literature suggested that multifactorial interventions tailored to individual patient characteristics were most effective in preventing falls. These interventions included comprehensive assessment and management of modifiable risk factors, such as impaired mobility, medication use, environmental hazards, and impaired cognition (Cameron et al., 2012; Oliver et al., 2010). Therefore, the team decided to adopt a comprehensive, multifactorial approach in their interventions.
2. Expert Advice:
Seeking guidance from experienced healthcare professionals who specialize in fall prevention was another crucial source of evidence for decision-making. Experts in the field, such as nurse educators, clinical specialists, and physical therapists, were consulted to ensure the implementation of best practices.
These experts provided insights into the assessment tools, selection of appropriate interventions, and unique considerations for different patient populations. Their expertise was valuable in helping the team navigate the complex nature of fall prevention and tailor interventions to individual patient needs.
3. Local Data and Clinical Experience:
The healthcare team also utilized local data from their own clinical setting to inform their decisions. They examined the records of fall incidents within the unit to identify common patterns and potential causal factors. This data included patient demographics, time of falls, characteristics of fall-related injuries, and other relevant variables. Analyzing this information allowed the team to target specific areas for improvement and develop proactive strategies to prevent falls within their unit.
Furthermore, the team incorporated their own clinical experience and knowledge into decision-making. The nurses shared their insights regarding patient behaviors and environmental factors that could contribute to falls. This experiential knowledge, combined with research evidence and expert advice, contributed to a more comprehensive understanding of the problem and the development of effective interventions.
Conclusion:
In summary, addressing the higher incidence of falls within the clinical setting requires evidence-based decision-making. In the case discussed, the healthcare team utilized a variety of sources of evidence, including research literature, expert advice, local data, and clinical experience. By adopting a multifactorial approach based on robust evidence, the team was able to implement effective fall prevention interventions. This underscores the importance and benefits of evidence-based practices in promoting patient safety and quality of care.
References:
Cameron, I. D., Dyer, S. M., Panagoda, C. E., Murray, G. R., Hill, K. D., Cumming, R. G., Kerse, N., & Gillespie, L. D. (2012). Interventions for preventing falls in older people in nursing care facilities and hospitals. Cochrane database of systematic reviews, (12), CD005465.
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.
Oliver, D., Connelly, J. B., & Victor, C. R. (2010). Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment: systematic review and meta-analyses. BMJ (Clinical research ed.), 340, c546.