Article Title
The critique is based on the article “Catching Quality Before It Falls: Preventing Falls and Injuries in the Adult Emergency Department.” The title accurately represents the content discussed in the article and effectively conveys the study’s primary focus. The article’s title delves into providing quality care to prevent falls and injuries. The article further provides the context as falls and injuries predominantly affect the adult population and occur in the emergency department. The context provides the best locale to focus quality interventions to ensure falls and injuries among older adults are reduced.
Abstract
The abstract is neatly presented, clear, concise, and informative. It contains four major sections that provide a sufficient summary of the paper, including the problem, methods, results, and discussion. Keywords are listed at the end of the abstract and include fall, injury, ED, adult, fall prevention, and fall risk. The keywords provide a concise and accurate summary of the research paper’s content and help communicate the study’s main topic, scope, and focus.
Introduction
The paper begins with an introduction that provides background information on falls and injuries. Stoeckle et al. (2019) highlight the statistics behind unintentional falls regarding ED visits and the cost to the healthcare system. The paper further identifies the intrinsic and extrinsic factors that cause falls and their risks. The information adequately provides a general overview of the problem. It is enhanced by referencing a sizeable Midwestern hospital with a high prevalence of falls at the trauma ED. The introduction fails to provide clear objectives of the study and does not list any hypotheses.
Literature Review
A significant limitation of the paper is that it needs to contain a literature review. The review would have provided a comprehensive and up-to-date understanding of the problem of falls and injuries in adult ED. It would also have provided context and backing to the study’s objectives. The literature review would also identify any outstanding gaps or biases in research conducted on the subject.
Methodology
The methodology included the design and the multifactorial interventions applied. The study’s design highlights the nature of the study, which was categorized as a quality improvement initiative and not a research initiative (Stoeckle et al., 2019). The initiative aimed to implement a change process at the trauma ED at a large Midwestern hospital in 2017. The change would be enacted using Lippitt’s change theory, which highlights seven steps to apply to the process. The authors did not identify any potential sources of bias or limitations in the study. The study was based on three multifactorial interventions, and the first approach involved re-educating the nursing staff about various components of falls. Secondly, the authors implemented a yellow stop sign for patients at high risk for falls, and the last intervention was to educate the patients or their families.
The methodology did not specify the sample size but showed the process of data collection based on multifactorial interventions. According to Stoeckle et al. (2019), data for the change process was collected weekly for the first two weeks to estimate staff adherence. Afterward, data was collected every six months using patient interviews, chart audits, and visualization of the yellow stop signs, during which feedback was provided to staff in real time. The effectiveness of the interventions was evaluated using electronic health records (EHRs). The overall outcome indicates a decline in falls, and injuries were observed.
Results and Discussion
The results have been presented clearly but must be analyzed properly. The general finding was on the enhanced awareness of high-fall-risk patients and communication among parties involved in the ED. The discussion provides an interpretation of the situation at the medical facility by indicating the rationale for the high frequency of falls and injuries. Stoeckle et al. (2019) provide alternative explanations and limitations encountered in the study. They identify potential challenges, including inadequate funding, storage space, supplies, sign fatigue, and resistance to change within the ED staff. They identified a few root causes and proposed the need for future research. The study did not involve overgeneralizations and recommended developing a fall-risk assessment tool that effectively reflects the specific circumstances of the ED patient population.
Implications and Contribution
The article helps to expand the current state of understanding of falls and injuries in the ED, which is limited. Most scientific studies focus on inpatient services, even as the ED carries a higher risk of falls and injuries. The article provides a theoretical contribution by suggesting that emergency nurses, who are at the front line for evaluating the risk of falls, should be proactive in implementing necessary safeguards to prevent falls and injuries in a vulnerable hospital setting. It suggests a policy intervention to facilitate leadership support and continuous evaluation for a change and promote a safety culture.
Summary and Conclusion
The study investigated the multifactorial interventions that can help to prevent falls through a change process. The article was written with clarity and organization, using concise and clear language that speaks to the intended audience. No grammar, spelling, or formatting errors were spotted. The study was grounded on recent, appropriate, and relevant references, recent. Twenty-two sources were used but only covered some essential studies due to a lack of literature review. The citation style used was applied accurately and consistently throughout the paper.
Reference
Stoeckle, A., Iseler, J. I., Havey, R., & Aebersold, C. (2019). Catching quality before it falls: Preventing falls and injuries in the adult emergency department. Journal of Emergency Nursing, 45(3), 257–264. Web.