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/ Uncategorized / Topic: Implementation of a Fall Prevention Bundle in Inpatient Rehabilitation Setting to Reduce Fall Incidence and Improve Patient Safety For this assignment, you will submit your SYNTHESIZED COMPREHENSIVE LITERATURE REVIEW using the a
Topic: Implementation of a Fall Prevention Bundle in Inpatient Rehabilitation Setting to Reduce Fall Incidence and Improve Patient Safety For this assignment, you will submit your SYNTHESIZED COMPREHENSIVE LITERATURE REVIEW using the a
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NOTE: All submitted assignments are required to follow APA guidelines. “Current research” is considered within 5-years. Your Turnitin Score typically should be under 24%.
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· Write an 8-page paper EXCLUDING title page and references:
Topic: Implementation of a Fall Prevention Bundle in Inpatient Rehabilitation Setting to Reduce Fall Incidence and Improve Patient Safety
For this assignment, you will submit your SYNTHESIZED COMPREHENSIVE LITERATURE REVIEW using the articles from the evaluation table below.
The reader should be able to distinguish how your scholarly project fits within the research and how it is significant.
Important components to include in the assignment are:
You will use articles from the evaluation tables previously submitted. See evaluation tables below. Please select at least 10-15 articles from the evaluation tables provided below for this literature review.
Theoretical framework: Describe any theoretical or conceptual frameworks that serve as a guide for your project, summarize the frameworks, and explain how they relate to and provide support for your problem or population of interest.
Synthesis and analysis of evidence (research) related to the problem or population of interest: Address the overall strengths, weaknesses, limitations, and gaps of the research. It is very important that this section provide a comprehensive review of the literature and contain a minimum of 8 pages and 10-15 articles from the evaluation tables provided below.
· For this assignment, you will submit your comprehensive literature review using the articles from the
· evaluation table below.
· Your literature review should present the strengths, weaknesses, and gaps in your current knowledge.
· The reader should be able to distinguish how your scholarly project ts within the research and
· how it is signicant. The literature review should provide a theoretical basis for your work, show what
· has been done by others, and set the stage for your work. You should be able to identify the GAP in the
· literature, which your project is going to be striving to !ll.
· Important components to include in the assignment are:
· · Theoretical framework:$Describe any theoretical or conceptual frameworks that serve as a guide
· for your project, summarize the frameworks, and explain how they relate to and provide support for
· your problem or population of interest.
· · Synthesis and analysis of evidence (research) related to the problem or population of
· interest:$Address the overall strengths, weaknesses, limitations, and gaps of the research. It is
· very important that this section provide a comprehensive review of the literature and contain a
· minimum of ten pages with 10 articles
For this assignment, you will submit your comprehensive literature review using the articles from the
evaluation table below.
Your literature review should present the strengths, weaknesses, and gaps in your current knowledge.
The reader should be able to distinguish how your scholarly project ts within the research and
how it is signicant. The literature review should provide a theoretical basis for your work, show what
has been done by others, and set the stage for your work. You should be able to identify the GAP in the
literature, which your project is going to be striving to !ll.
Important components to include in the assignment are:
· Theoretical framework:$Describe any theoretical or conceptual frameworks that serve as a guide
for your project, summarize the frameworks, and explain how they relate to and provide support for
your problem or population of interest.
· Synthesis and analysis of evidence (research) related to the problem or population of
interest:$Address the overall strengths, weaknesses, limitations, and gaps of the research. It is
very important that this section provide a comprehensive review of the literature and contain a
minimum of ten pages with 10 articles
For this assignment, you will submit your comprehensive literature review using the articles from the
evaluation table below.
Your literature review should present the strengths, weaknesses, and gaps in your current knowledge.
The reader should be able to distinguish how your scholarly project ts within the research and
how it is signicant. The literature review should provide a theoretical basis for your work, show what
has been done by others, and set the stage for your work. You should be able to identify the GAP in the
literature, which your project is going to be striving to !ll.
Important components to include in the assignment are:
· Theoretical framework:$Describe any theoretical or conceptual frameworks that serve as a guide
for your project, summarize the frameworks, and explain how they relate to and provide support for
your problem or population of interest.
· Synthesis and analysis of evidence (research) related to the problem or population of
interest:$Address the overall strengths, weaknesses, limitations, and gaps of the research. It is
very important that this section provide a comprehensive review of the literature and contain a
minimum of ten pages with 10 articles.
Rubric Criteria:
· Thoroughly appraised appropriate evidence sources and provided a descriptive and detailed analysis of the research reviewed
· Anchored the clinical problem or topic in a theoretical or conceptual model that is clearly described. Clearly and thoroughly described the components of the model and the relationship of the model to the problem or topic
· Presented a literature review that is well organized and demonstrates logical sequencing based on the topic or clinical problem.
· Reached detailed conclusions based on the literature reviewed and included the strengths and gaps of the current research.
· Clearly demonstrated how the project fits within the existing evidence.
· Used correct spelling, grammar, and professional vocabulary. Cited all sources using APA format.
Guo, X., Wang, Y., Wang, L., Yang, X., Yang, W., Lu, Z., & He, M. (2022). Effect of a fall prevention strategy for the older patients: A quasi‐experimental study. Nursing Open, 10(2). https://doi.org/10.1002/nop2.1379
Heng, H., Kiegaldie, D., Shaw, L., Jazayeri, D., Hill, A.-M., & Morris, M. E. (2022). Implementing patient falls education in hospitals: a mixed-methods trial. Healthcare, 10(7), 1298. https://doi.org/10.3390/healthcare10071298
Montero-Odasso, M. M., Kamkar, N., Pieruccini-Faria, F., Osman, A., Sarquis-Adamson, Y., Close, J., Hogan, D. B., Hunter, S. W., Kenny, R. A., Lipsitz, L. A., Lord, S. R., Madden, K. M., Petrovic, M., Ryg, J., Speechley, M., Sultana, M., Tan, M. P., van der Velde, N., Verghese, J., & Masud, T. (2021). Evaluation of clinical practice guidelines on fall prevention and management for older adults: a systematic review. JAMA Network Open, 4(12), e2138911–e2138911. https://doi.org/10.1001/jamanetworkopen.2021.38911
Scheidenhelm, S., Astroth, K. S., DeLong, K., Starkey, C., & Wolfe, D. (2020). Retrospective analysis of factors associated with a revised fall prevention bundle in hospitalized patients. JONA: The Journal of Nursing Administration, 50(11), 571–577. https://doi.org/10.1097/nna.0000000000000939
Evaluation Table 2
First Author (Year)
Conceptual Framework
Design/Method
Sample & Setting
Major Variables
Studied (and Definitions)
Measurement
Data Analysis
Findings
Appraisal: Worth to
Practice
Bargmann & Brundrett
(2020)
Iowa Model
Evidence-based practice
26-bed medical-surgical telemetry
unit in a 352-bed Level 1 military trauma center
Fall rate: the number of falls
per 1,000 patient days.
Patient education:Structured education on fall risk and
prevention.
Staff compliance: adherence to
fall prevention interventions.
Audit of adherence to fall
prevention interventions, patient surveys, fall rate tracking
Comparison of pre-and
post-implementation fall rates, staff compliance rates, and patient understanding
of fall risk
55% decrease in fall rate.
89% staff compliance with
interventions.
Longest consecutive fall-free
days since 2015: 87 and 88 days.
Proves that the implementation of
a fall prevention bundle reduces fall incidence and improves patient safety.
Davenport et al.
(2020)
Modifiable fall-risk factors
Secondary analysis
400 older adult patients in an
academic urban emergency department
Fall-risk factors: modifiable
conditions contributing to falls.
Provider identification: the rate
of missed opportunities to diagnose risk factors.
Intervention strategies: actions
taken to mitigate fall risk.
Chart review of patient records,
comparison with standardized fall assessment
Quantification of missed
opportunities, statistical comparison of identified vs. unidentified risk
factors
96% of modifiable fall-risk
factors were missed by providers.
Specifically, visual acuity and
high-risk medications are the most overlooked factors.
Highlights that significant gaps
in fall-risk identification exist and thus emphasizes the need for improved
screening protocols.
Goldberg et al.
(2020)
Geriatric Acute and Post-acute
Fall Prevention
Randomized controlled trial
110 noninstitutionalized older
adults over 65 years old in two urban academic emergency departments
Fall-related emergency department
visits: the number of visits within six months.
Hospitalizations: all-cause and
fall-related.
Adherence to pharmacy and
physical therapy recommendations
Patient surveys, electronic
health record review, adherence tracking
55% reduction in fall-related
emergency department visits.
57% reduction in all
hospitalizations.
Moderate adherence to
recommendations: pharmacy at 73% and physical therapy at 68%.
Provides evidence that a
structured, multidisciplinary approach improves patient safety and reduces
costly fall-related events.
Kelley et al. (2023)
Fall safety agreement
Quality improvement project
Three surgical units in an urban
hospital
Fall rate: the number of falls
reported.
Staff adherence: compliance with
fall prevention interventions.
Patient education: structured
education and agreement signing.
Weekly data collection on staff
adherence, patient education completion, and fall rates
Comparison of pre-and
post-implementation adherence rates, patient education rates, and fall
incidence
80.8% staff adherence.
92% patient education completion.
67.1% implementation of the Fall
T.I.P.S. tool and no falls were reported during the project.
Provides evidence that a fall
prevention bundle is effective in
reducing fall incidence and
improving patient safety.
Pop et al. (2020)
Multifactorial fall prevention
Quality improvement project
Emergency department (ED) in a
676-bed urban academic medical center
Fall risk screening:
Identification of at-risk
patients.
Multifactorial interventions:
fall prevention measures.
Staff engagement: involvement in
implementation.
Audit of adherence to fall
prevention interventions, patient education completion, fall rate tracking
Comparison of pre-and
post-implementation fall rates, staff compliance rates, and patient education
effectiveness
96% of ED arrivals screened for
fall risk.
86% of at-risk patients received
fall precautions.
The quarterly fall rate reduced
to 0.27 falls per 1,000 visits.
Provides evidence that a tailored
fall prevention bundle that incorporates multifactorial interventions and
staff engagement improves fall risk identification and prevention.
References
Bargmann, A. L., & Brundrett, S. M. (2020). Implementation of a Multicomponent Fall Prevention Program: Contracting With Patients for Fall Safety. Military Medicine, 185(2), 28–34. https://doi.org/10.1093/milmed/usz411
Davenport, K., Alazemi, M., Sri-On, J., & Liu, S. (2020). Missed Opportunities to Diagnose and Intervene in Modifiable Risk Factors for Older Emergency Department Patients Presenting After a Fall. Annals of Emergency Medicine, 0(0). https://doi.org/10.1016/j.annemergmed.2020.06.020
Goldberg, E. M., Marks, S. J., Resnik, L. J., Long, S., Mellott, H., & Merchant, R. C. (2020). Can an emergency department–initiated intervention prevent subsequent falls and health care use in older adults? A randomized controlled trial. Annals of Emergency Medicine, 76(6). https://doi.org/10.1016/j.annemergmed.2020.07.025
Kelley, R. J., Gutchell, V., & O’Neill, K. (2023). Preventing Falls in the Surgical Setting by Implementing a Fall Prevention Bundle. Journal of PeriAnesthesia Nursing, 38(4), e27. https://doi.org/10.1016/j.jopan.2023.06.025
Pop, H., Lamb, K., Livesay, S., Altman, P., Sanchez, A., & Nora, M. E. (2020). Tailoring a Comprehensive Bundled Intervention for ED Fall Prevention. Journal of Emergency Nursing, 46(2), 225-232.e3. https://doi.org/10.1016/j.jen.2019.11.010
Evaluation Table 3
First Author
(Year)
Conceptual
framework
Design/Method
Sample &
setting
Major Variables
(and Definitions)
Measurement
Data Analysis
Findings
Appraisal: Worth
to Practice
Burns et al.
(2022)
Fall risk
screening
Prospective
longitudinal cohort study
1,905
community-dwelling older adults in the U.S.
Fall incidence:
occurrence of falls within 12 months.
Screening tool effectiveness: sensitivity and specificity of fall-risk tools.
Monthly
fall-tracking surveys; baseline and final assessments
Fall rate reduction: change in falls per 1,000 patient days.
Adherence audits;
fall rate tracking; strategy classification.
Pre- vs
post-implementation comparisons of fall rates, adherence, and strategy
effectiveness.
Median fall-rate
decline of 0.9 per 1,000 patient days.
Median adherence
is 65%; most studies employed educational strategies.
Reiterates that
need to apply strategies, such as education, for consistent fall reduction in
rehab settings.
References
Burns, E. R., Lee, R., Hodge, S. E., Pineau, V. J., Welch, B., & Zhu, M. (2022). Validation and comparison of fall screening tools for predicting future falls among older adults. Archives of Gerontology and Geriatrics, 101, 104713. https://doi.org/10.1016/j.archger.2022.104713
Ganz, D. A., & Latham, N. K. (2020). Prevention of falls in community-dwelling older adults. New England Journal of Medicine, 382(8), 734–743. https://doi.org/10.1056/nejmcp1903252
Montero-Odasso, M., van der Velde, N., Martin, F. C., Petrovic, M., Tan, M. P., Ryg, J., Aguilar-Navarro, S., Alexander, N. B., Becker, C., Blain, H., Bourke, R., Cameron, I. D., Camicioli, R., Clemson, L., Close, J., Delbaere, K., Duan, L., Duque, G., Dyer, S. M., & Freiberger, E. (2022). World guidelines for falls prevention and management for older adults: A global initiative. Age and Ageing, 51(9), 1–36. https://doi.org/10.1093/ageing/afac205
Morris, M., Webster, K., Jones, C., Hill, A.-M., Haines, T., McPhail, S., Kiegaldie, D., Slade, S., Jazayeri, D., Heng, H., Shorr, R., Carey, L., Barker, A., & Cameron, I. (2022). Interventions to reduce falls in hospitals: A systematic review and meta-analysis. Age and Ageing, 51(5), 1–12. https://doi.org/10.1093/ageing/afac077
Spoon, D., de Legé, T., Oudshoorn, C., van Dijk, M., & Ista, E. (2024). Implementation strategies of fall prevention interventions in hospitals: a systematic review. BMJ Open Quality, 13(4), e003006. https://doi.org/10.1136/bmjoq-2024-003006
Evaluation Table 4
First Author
(Year)
Conceptual
Framework
Design/Method
Sample &
Setting
Major Variables
Studied (and Their Definitions)
Measurement
Data Analysis
Findings
Appraisal
Dykes et al.
(2023)
Evidence-based
fall prevention.
Economic evaluation.
10,176 patients
with falls and 29,161 matched controls in 8 U.S. hospitals.
Fall incidence:
number of falls pre/post-intervention.
Cost of falls: financial burden per event.
Cost savings: net avoided costs per 1,000 patient days.
Interrupted time
series; matched case-control cost analysis.
Wide variation in
practices; resource-intensive strategies underused; limited interdisciplinary
approaches.
Reveals the need
for tailored, resource-appropriate strategies and interdisciplinary
collaboration in inpatient rehab settings.
References
Dykes, P. C., Bowen, M. C., Lipsitz, S., Franz, C., Adelman, J., Adkison, L., Bogaisky, M., Carroll, D., Carter, E., Herlihy, L., Lindros, M. E., Ryan, V., Scanlan, M., Walsh, M.-A., Wien, M., & Bates, D. W. (2023). Cost of inpatient falls and cost-benefit analysis of implementation of an evidence-based fall prevention program. JAMA Health Forum, 4(1), e225125. https://doi.org/10.1001/jamahealthforum.2022.5125
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), 1–12. https://doi.org/10.1186/s12877-020-01515-w
Li, S., & Surineni, K. (2024). Falls in hospitalized patients and preventive strategies: A narrative review. The American Journal of Geriatric Psychiatry: Open Science, Education, and Practice, 5, 1–9. https://doi.org/10.1016/j.osep.2024.10.004
Randell, R., McVey, L., Wright, J., Zaman, H., Cheong, V.-L., Woodcock, D. M., Healey, F., Dowding, D., Gardner, P., Hardiker, N. R., Lynch, A., Todd, C., Davey, C., & Alvarado, N. (2024). Practices of falls risk assessment and prevention in acute hospital settings: a realist investigation. Health and Social Care Delivery Research, 12(5), 1–194. https://doi.org/10.3310/JWQC5771
Turner, K., Staggs, V. S., Potter, C., Cramer, E., Shorr, R. I., & Mion, L. C. (2022). Fall prevention practices and implementation strategies. Journal of Patient Safety, 18(1), e236–e242. https://doi.org/10.1097/pts.0000000000000758