Introduction
Evidence-based practices promote nursing by regularly updating practices, boosting nurses’ engagement, and adding to the profession’s science. This research paper summarizes insights from descriptive statistics from five quantitative research publications on the quality of patient support in acute care institutions. The primary aim is to answer the research question based on the concepts and best practices established in the articles, emphasizing the effect of nursing shifts on decreasing falls in acute care settings. In healthcare, falls result in damage and death for people of all ages, although the danger of falling significantly rises with age. Appropriate intervention is required to enhance the quality of treatment and levels of patient satisfaction for patients requiring acute care.
Research Question
This research paper adopts the research question: In an acute care situation, can planned hourly rounding by nurses and members of the multidisciplinary team assist in reducing patient falls compared to no hourly rounding? Today, psychiatric mental health specialists have undertaken studies correlating the quality of hospital schedules with the likelihood of falls in acute care institutions (Pahor, 2019). The insights give recommendations for evidence-based optimal nurse management practices. The selection criteria required that the publications be quantitative research less than five years old and provide statistical analyses with at least 95% confidence levels.
Highest Levels of Evidence Studies Related to Clinical Questions
Article #1
The first article examines the patient’s viewpoint on fall prevention in an acute care context. The researchers agree that falls are one of the most prevalent adverse events in hospitals and may lead to unnecessary patient injury, longer lengths of stay, and higher healthcare expenses (Radecki et al., 2018). The study acknowledges the need to understand fall risk and prevention from the patient’s viewpoint despite the scant research on preventing falls. The purpose of the semi-structured interviews with twelve participants at an academic healthcare facility is to understand the patient’s viewpoint. The findings of the qualitative analysis indicated three significant themes, including self-perception, viewpoint on the effect of treatments, and the patient’s attitude toward participation in the fall prevention plan.
The article demonstrates that most fall prevention programs prefer clinician-led plan formulation and execution. The study underlines that the focus of patient fall evaluations must shift from clinicians to patients. The research demonstrates that nurses must cultivate connections with patients to comprehend their requirements better. The researchers assert that implementing patient-centered programs may lessen the dependence on bed alarms and enable the deployment of interventions designed to reduce modifiable risk factors associated with falls.
Article #2
The second article investigates the effects of fall and injury prevention measures in acute care hospitals. The study highlights that falls and falls resulting in injury are serious patient safety problems in acute care hospitals (Zhao et al., 2019). The researchers recognize that inpatient falls and falls resulting in injury often impose additional cost burdens on patients, family members, and healthcare institutions. The statistical analysis of the obtained data indicates that falls are more prevalent among older patients with walking and balance issues. The second most common cause of falls is medication usage among patients.
Similarly, the researchers note that visual issues lead to around one-fourth of falls in acute care institutions. The study addresses the clinical implications of accidents and offers suggestions for adult inpatient falls and injury mitigation (Zhao et al., 2019). The article suggests that fall prevention should involve addressing issues related to exposure to falls, such as staff shortages, which often result in burnout. The researchers suggest acute care hospitals optimize their present fall prevention efforts.
Article #3
The third article analyses the connection between inpatient falls, bedside shift reports (BSR), and hourly rounds (HR). The researchers recognize that falls are a significant health issue requiring rapid evidence-based treatments (Sun et al., 2020). The authors note that while BSR and HR are shown to minimize falls, studies often rely on self-reported data about nurse conformance with HR and bedside report procedures. The research gathered observational data on nursing duties, such as BSR and HR. Throughout 281 shifts, nine thousand six hundred ninety-three measurements were collected on eleven units at four hospitals (Sun et al., 2020, p.358). The regression model included patient frequency, shift, weekday, and HR in the data analysis. The data demonstrated that shift and day of the week were linked with falls but not BSR, HR, or the number of patient interactions. The researchers suggest that increased nurse visits may reduce the incidence of patient falls. Bedside shift reports and human resources may need comprehensive, ongoing interventions for long-lasting results.
Article #4
The fourth article examines the relationship between unperformed care and temporary nursing staff ratios in acute care hospitals. The researchers undertook a cross-sectional survey of registered nurses to evaluate the worldwide effect of the lack of health professionals (Senek et al., 2020). This study investigates the prevalence of neglect, staffing shortages, and temporary staffing in acute care settings. The preferred approach was to analyze secondary data from an RCN-administered online survey of nurses from health facilities and trusts in all four UK nations. Staffing and “care left undone” indicators were generated from replies from 8841 registered nurses in the United Kingdom (Senek et al., 2020). In the investigation, a locally smoothed scatterplot smoothing regression analysis was employed to analyze the association between occurrences of ‘care left undone’ and full complement, modestly and substantially understaffed shifts, and percentages of temporary personnel.
The data revealed a discrepancy in the number of patient falls among hospital departments. The incidence of ‘care left undone’ was most significant in Emergency Departments at 48.4% and lowest in Theatre settings at 21.0%, according to the study analysis (Senek et al., 2020, p.4). The likelihood of ‘care left undone’ rose as the percentage of temporary personnel grew. The trend further demonstrated that on shifts with a full complement of nursing staff, an increase in the percentage of temporary employees from 0% to 10% raises the risk of care being neglected, resulting in falls of 6%. (Senek et al., 2020, p.7). The researchers note that increasing the number of temporary nurses is connected with more excellent rates of care left undone by nursing personnel, as reported by patients. The insights have substantial consequences for nursing administrators and policymakers.
Article #5
In the fifth article, persons with dementia are studied as individuals susceptible to falls due to their reactive actions. The researchers admit that healthcare workers perceived responsive behaviors as challenging when caring for people with dementia (Yous et al., 2019). The research investigates nurses’ perspectives on caring for dementia patients exhibiting responsive behaviors in acute medical settings. This study used semi-structured interviews with ten nurses and five allied health workers from Ontario metropolitan hospitals with acute medical situations (Yous et al., 2019). Interviews were performed with allied health workers to determine their opinions on care delivery for dementia patients exhibiting responsive behaviors. The data were evaluated using Braun and Clarke’s experiential thematic analysis.
The researchers identified a pattern of similar motifs concerning caring for persons with responsive behaviors. The focus topics were beliefs that providing care is a challenging experience and the need to use pharmaceutical and moderate non-pharmacological ways to assist older persons with responsive behaviors. Equally, care providers were worried that acute medical environments were incompatible with dementia care principles owing to an emphasis on acute care needs and limited time. Important care facilitators agreed upon strong interprofessional teamwork and high continuity of care. The researchers acknowledge that the results give nurses who provide care to patients with responsive behaviors in acute medical settings with recommendations for preventing falls. Staffing increases and educational reinforcements, such as an annual evaluation of dementia care education and in-services, are among the recommended solutions.
A Discussion on Insights from the Statistical Outcomes and Findings
Most studies acknowledge the necessity for clinician-led plan formulation and enough staffing to ensure the successful implementation of fall prevention intervention, according to a synthesis of the articles’ findings. Radecki et al. (2018) remark that the evaluation of patient falls must transition from clinician-centric to patient-centric. The method in patient management involves nurses establishing connections with patients to comprehend their requirements better. Sun et al. (2020) acknowledge that bedside shift reports and HR may need comprehensive and persistent treatments for long-term outcomes. Consequently, there is an evident need for adequate staffing in acute care institutions to reduce instances of patient neglect.
Observations on the importance of appropriately staffing departments have been made in research comparing the quality of treatment during fully staffed shifts with sessions with temporary nursing staff assistance. For example, Senek et al. (2020) indicate that an increase in the percentage of temporary nurse administrators is related to an increase in the rate of self-reported care neglected by nursing staff. Yous et al. (2019) acknowledge the need for more excellent assistance for nurses dealing with patients exhibiting responsive behaviors in acute medical settings. In order to prevent falls in acute care settings, there is an awareness of the necessity for enough staffing, the implementation of technology, and the cultivation of good communication.
Recommend Technology Use for Patient Monitoring
In improving the impact of acute care, nurses should be guided on utilizing emerging healthcare technologies that can be useful in remotely monitoring and mitigating falls in acute care institutions. For example, Remote patient monitoring (RPM) may be used as a healthcare delivery intervention that uses technology to monitor patient health and provide timely feedback (Salehi et al., 2020). Historically, nurses have represented holistic care, demanding participation in promoting technology integration in critical care support systems (Ram et al., 2019). Preventing falls requires adequate nurse support for managing burnout and using technology to enhance patient care quality.
Conclusion
The insights from the statistical outcomes of the articles show that planned hourly rounding by nurses and members of the multidisciplinary team may reduce patient falls during hospitalization compared to no hourly rounding. In acute care and fall prevention, there is unanimity that the notion of humanizing and quality treatment remains a topic of concern. As a requirement for preventing falls in acute care settings, it is advised that healthcare institutions implement RPM technology to enhance the quality of patient care. Further study should concentrate on the influence of present technologies in managing falls in acute care. Nurses should seek to understand the critical success factors for humanizing informatics care in acute care.