Assignment 3: PICOT Question and an Evidence-Based Approach Essay Example

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PICOT Question and an Evidence-Based Approach

Capella University NURS-FPX4030: Making Evidence-Based Decisions

Assignment 3: PICOT Question and an Evidence-Based Approach

Definition of the Practice Issue to Be Explored Under the PICOT Approach

Approximately seven hundred thousand to one million patients staying in US healthcare
facilities fall each year, encountering lacerations, fractures, internal bleeding, and other fatal
injuries that prolong their hospital stay and raise healthcare utilization and costs (AHRQ, 2018).
In particular, falls among elderly patients in US medical care institutions are on the rise.
According to the CDC (2018), in 2016 alone, 29,668 American patients aged 65 years or older
died due to a falling incident, implying that falls caused the death of 6.2 out of every 10,000 US
seniors in that year. The American public health organization states that in 2007, the US had an
average of 4.7 fall-associated deaths for every 10,000 older adults, meaning that the fall-related
mortality rate in the US has grown by 31 percent in ten years. The high falls’ prevalence and fallrelated death rates among hospitalized patients have prompted hospitals and other healthcare
centers to adopt strategies, such as bed absence detectors and safety/hourly rounds, to minimize
and prevent falls among patients during their stays in medical care facilities (Weil, 2015). Based
on this backdrop information, the PICOT question that this paper aims to answer is, “Among
hospitalized geriatric patients aged 65 years or older (P), how effective are patient bed absence
sensors (I) compared to safety/hourly rounds (C) in preventing or reducing fall incidents (O)
during patients’ stay in healthcare facilities (T) ?”’

Identification of Sources of Evidence That Could Be Potentially Effective in Answering the
PICOT Question

A couple of research evidence sources could be potentially useful in answering the
PICOT question stated above. They include research articles by Subermaniam et al. (2017) and
Johnson (2015). The criteria used to determine the articles’ potential to answer the PICOT

question identified above comprised appraising the evidence sources’ validity based on whether
they adopted an experimental research approach and underwent the peer-review process.
Additionally, the selection criteria involved evaluating the manuscripts’ usefulness based on their
focus topics’ relevance to the PICOT question highlighted in the paragraph above. The
evaluation process revealed that Subermaniam et al.’s (2017) document and Johnson’s (2015)
paper present the findings of experimental studies that strictly adhered to the scientific research
process. Additionally, the articles are peer-reviewed sources that focus on the topic of bed
absence detectors and safety rounds’ effectiveness in preventing falls among hospitalized
patients, implying that they are valid, credible, and relevant enough to contribute to answering
the PICOT question mentioned above.

Explanation of the Articles’ Findings Relevant to the PICOT Question

Johnson (2015) investigated the hourly rounding strategy’s feasibility and effectiveness in
preventing and minimizing fall incidents among patients admitted to a trauma setting. According
to the researcher, when using the hourly rounding strategy, clinicians visit patients every hour
during their stay in healthcare facilities to proactively address their needs, identify, and attend to
issues that may cause them to fall. He found that although hourly rounding is a feasible strategy
for preventing patient falls, nurse-related factors, such as inadequate staffing and time and the
lack of enthusiasm to conduct hourly rounds, limit its effectiveness in averting and reducing falls
among hospitalized patients. In contrast, Subermaniam et al. (2017) examined bed absence
sensors’ effectiveness in detecting older patients’ bed exits and preventing falls during their stay
in an East Asian healthcare center. They found that bed absence detectors effectively detect bed
exit episodes among elderly patients, alert nurses about patients’ departure from the bed, and
prevent falls among hospitalized geriatric patients.

The Relevance of the Articles’ Findings to Making Decisions to Address the PICOT
Question

Research findings by Subermaniam et al. (2017) and Johnson (205) show that bed
absence detectors are more effective than safety/hourly rounds in preventing or reducing falls
among hospitalized geriatric patients during their stay in healthcare facilities. The researchers’
study results indicate that clinicians or healthcare organization administrators should prioritize
bed absence sensors over safety/hourly rounds when making decisions regarding strategies to
prevent or minimize falls among patients during their hospital stay. However, it is vital to note
that Johnson’s (2015) findings indicate that safety/hourly rounds have a significant potential to
prevent or mitigate patient falls, but nurse-related factors, such as staffing shortages and
inadequate time, reduce their fall prevention effectiveness. Healthcare practitioners and facility
managers can leverage Johnson’s (2015) research outcomes to formulate and implement policies
that address nurse concerns and nurse-related issues, such as staffing shortages and lack of
enthusiasm, which diminish safety/hourly rounds’ falls aversion efficacy. Undoubtedly, with
adequate nursing staff and motivated nurses, safety/hourly rounds could be as effective as bed
absence sensors in preventing falls among patients during their hospital stay.

Conclusion

Overall, high patient fall incidents and elevated fall-related mortality rates among
hospitalized patients have prompted healthcare facilities and clinicians to take preventive
measures, such as conducting safety/hourly rounds and using bed absence detectors, to mitigate
falls among patients during their stay in medical care facilities. Although falls are prevalent
among patients of all ages, their incidence and mortality rates are higher among older patients
than any other age group. Hence, the PICOT question that this paper aimed to answer was,

“Among hospitalized geriatric patients aged 65 years or older (P), how effective are patient bed
absence sensors (I) compared to safety/hourly rounds (C) in preventing or reducing fall incidents
(O) during patients’ stay in healthcare facilities (T) ?” Research evidence indicates that bed
absence detectors are more effective than safety/hourly rounds in averting or mitigating falls
among hospitalized geriatric patients. Consequently, healthcare organization administrators or
providers should prioritize bed absence sensors over safety/hourly rounds when making
decisions about effective fall prevention strategies to adopt. However, healthcare facility
administrators should develop and implement policies to address the nurse-related bottlenecks to
safety/hourly rounds’ effectiveness, as they can be equally effective in preventing patient falls if
healthcare leaders attend to the factors that impede their efficacy.

References
Johnson, S. (2015). Measuring the effectiveness of a flexible multidisciplinary hourly round fall
prevention program (Doctoral dissertation, Columbia Southern University). Chico Digital
Repository (CDR). http://hdl.handle.net/10211.3/135864
Subermaniam, K., Welfred, R., Subramanian, P., Chinna, K., Ibrahim, F., Mohktar, M. S., & Tan,
M. (2017). The effectiveness of a wireless modular bed absence sensor device for fall
prevention among older inpatients. Frontiers in public health, 4, 292.
https://www.frontiersin.org/articles/10.3389/fpubh.2016.00292/full
The Agency for Healthcare Research and Quality (AHRQ). (2018, July). Preventing falls in
hospitals. AHRQ.
https://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/index.html
The Centers for Disease Control and Prevention (CDC). Death from falls among persons aged
≥65 years – the United States, 2007-2016. CDC.
https://www.cdc.gov/mmwr/volumes/67/wr/mm6718a1.htm#:~:text=The%20rate%20of
%20deaths%20from,)%20to%20142.7%20(Wisconsin).
Weil, T. (2015). Patient falls in hospitals: an increasing problem. Geriatric Nursing, 36(5), 342-

347. https://doi.org/10.1016/j.gerinurse.2015.07.004
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