Download and complete the Bare Bones Proposal Assignment. You will use content from your Problem Significance and Review of Literature and Methodology Assignments. Be sure to implement suggested faculty feedback from the assignments. Make sure you have responded to all portions of the grade rubric. You can simply combine these two assignments into one paper with revisions based on faculty feedback. This is a formal APA paper so you will need a title page and a reference page.
Title of the Paper
Name
Troy University
Title of Paper Upper and Lower Case Bolded
Type a brief introduction and statement of your problem here. You will use general statistics in this opening paragraph.
Significance of the Problem to Nursing
Begin discussion of the significance to nurse here—be sure you have two references.
Literature Synthesis
Begin with an introductory paragraph. Be sure to include the variables you intend to use in your study.
First Variable (replace the words ‘First Variable’ with the name of your first variable)
Discuss the findings from your literature search concerning the first variable you will discuss. Usually, it is the outcome variable from your PICO question.
Second Variable (replace the words ‘Second Variable’ with your second variable)
Discuss the finding from your literature search concerning the next variable. It usually comes from your PICO also.
Third Variable (if you have one—replace the words—delete this if you don’t have one).
Begin typing here.
Summary of Literature Synthesis
Summarize the findings from the literature and state why you need to conduct the study. Be sure at least two lines follow a bold heading at the bottom of a page. If not, tab the bold heading to the next page.
Purpose
Begin discussion of the purpose of the study here. Remember this must be two or more sentences.
Research Question/PICOT Question OR Hypothesis
Provide a clearly stated research question or hypothesis that contains the study variables and is congruent with the chosen research design. Label the heading accordingly (ie: specifically state whether you are providing a research question, PICOT question, or hypothesis). You can use your PICO as the research question.
Methodology
Design
Begin typing here. Specifically state the type of design and its appropriateness for the purpose of the study. You will need citations here to support your choice.
Control of Extraneous Variables
Begin typing here—describing potential extraneous variables–be sure to state how you will control for the extraneous variables.
Sampling Plan
Begin typing here—state the type of sampling plan (convenience, purposive, etc.). Be sure to use two or more sentences for a paragraph.
Target Population
Begin typing here—state the target population—use at least two sentences
Sample Size
Begin typing here—state the estimated sample size you anticipate—use at least two sentences.
Sampling Method
Begin typing here—describe how the sample will be obtained—at least two sentences.
Inclusion and Exclusion Criteria
Begin typing here
Data Collection Procedures
Begin typing here. Be sure to cover IRB, informed consent, and procedure for data collection.
Data Collection Measures
Begin typing here. Be sure to read the grade criteria; if you use an instrument you obtained from the literature, include information about the reliability and validity. Include as an appendix. The appendix would be written: The Beck Inventory (Appendix) will be used for…
If you have more than one appendix: The Beck Inventory (Appendix A) will be used… (describe the instrument, how many items, are they Likert scales, how are the scores interpreted, what is the reported reliability and validity). The Quality of Life Questionnaire (Appendix B) will be used… (then describe as above).
References
Begin typing here. The first line is flush left; the next lines are indented ½ inch. This is set to automatically indent subsequent lines. At the end of the reference, hit enter to begin the next reference in the flush left position.
For the next reference, follow the same procedure.
Using Fall TIPS (Tailoring Interventions for Patient Safety) to Prevent Patient Falls
Name
Troy University
Using Fall TIPS (Tailoring Interventions for Patient Safety) to Prevent Patient Falls
Hospitalized patients, especially the elderly, are often at high risk for falls. Among hospitalized patients, falls present a leading cause of preventable injuries, like those named above (Dykes et al., 2020). Falls are associated with additional days of hospitalization and injuries. Worldwide, falls cause about 424000 deaths annually (Aranda-Gallardo et al., 2018). Fall rates in U.S. hospitals range between 3.3 to 11.5 per 1000 patient days.
Significance of the Problem to Nursing
Unintentional falls among inpatients are a concern in health care institutions worldwide. According to the World Health Organization, falls are defined as accidental events that lead to a person lying on the ground, floor, or lower levels (Avanecean et al., 2017). Out of all the in-hospital falls, 25% often lead to injuries. According to Avanecean et al. (2017), up to 50% of hospitalized patients in the United States of America are at risk for falls. The risks for falls among hospitalized elderly patients in the U.S. remain high, leading to detrimental health effects. Therefore, there is a need to assess the effectiveness of Fall TIPS in reducing fall rates in hospitalized patients.
Literature Synthesis
The use of Fall TIPS can reduce fall rates in hospitalized patients. According to Avanecean et al. (2017), the use of conventional methods such as the fall risk assessment tools has failed to reduce fall rates consistently, hence the need for more patient-centered approaches. According to Duckworth et al. (2019), Fall TIPS provides individualized and patient-centered fall prevention measures. In their study, Duckworth et al. (2019) aimed to assess if Fall TIP modality can affect patient engagement regarding fall prevention, hence, its efficacy. Some of the variables the researcher intends to use in this study the independent variable is the Fall TIPS and the dependent variable is Fall rates.
Fall Rates
Fall rates are outcome measures that are used to assess the effectiveness of a fall prevention program. In this case, fall rates are used to determine whether the Fall TIPS intervention is efficient in reducing the incidents. Duckworth et al. (2019) reported a reduction in fall rates after implementing a fall reduction program. Fall rates can be calculated by counting the number of fall occurrences in a month or diving the number of falls by the number of patient bed days in April, then multiplying by 1000 to get fall rates per 1000 patient days.
The Use of Fall TIPS (Tailoring Interventions for Patient Safety)
According to Dykes et al. (2020), fall TIPS is a nurse-led, evidence-based fall-prevention intervention that uses bedside tools to communicate patient-specific risk factors for falls and a tailored prevention plan. Dykes et al. (2020) states further that Fall TIPS reduces patient falls by 25 and above. Therefore, the use of Fall TIPs will lead to a reduction in fall rates.
Summary of Literature Synthesis
Literature has indicated the dangers associated with falls among hospitalized elderly patients. The use of evidence-based fall prevention tools such as Fall TIPS can provide promising results. Literature has indicated how Fall TIPS can successfully reduce fall incidences. In this study, the two variables are Fall TIPS and fall rates. Both variables have been described in detail.
Purpose
The purpose of this study is to evaluate the effectiveness of Fall TIPS (Tailoring Interventions for Patient Safety) in reducing fall rates among hospitalized elderly.
PICO Question
In hospitalized elderly patients with a higher risk of falling (P), how does Fall TIPS (Tailoring Interventions for Patient Safety) (I) compared to no intervention (C) affect fall rates among the patients (O)?
Methodology
Design
The research design for this study is a quantitative quasi-experimental study design. The quasi-experimental design resembles experimental research but is not true experimental research (Mayhob & Amin, 2022). It is commonly used in the field setting, such as a hospital setting, where random assignment may be difficult or impossible. This study will include pre-and-post intervention (pre-posttest design) data about fall rates to evaluate the effectiveness of Fall TIPS (Mayhob & Amin, 2022). All the pre-and-post intervention data will be retrieved from the hospital’s electronic health record.
Control of Extraneous Variables
The extraneous variables in this study include mean age, causes of falls, diagnosis, and comorbidities. Age will be controlled by selecting people within the age bracket of 60 to 80 years old to ensure patients are elderly. The cause of falls and disease comorbidities are strenuous variables. To deal with the situation, only people who are not physically disabled were included. Those who have a physical disability and are likely to fall due to that were excluded. People who have psychiatric problems were also excluded to minimize the influence of extraneous variables.
Sampling Plan
A convenience sampling method will be used in this study to obtain the appropriate subject samples. This method of sampling is also called availability sampling (Khoja, 2021). It involves a non-probability sampling method that is based on data collection from every population member who is conveniently available to participate in the study.
Target Population
The study target includes hospitalized elderly people who are at risk for falls. Falls are more prevalent among the elderly than in the general population (Khoja, 2021). Hospitalized elderly people between the ages of 60 and 80 years old are targeted.
Sample Size
The sample size will include at least 58 patients, which is a 50 percent proportion of the overall patient population admitted to the hospital. A power analysis will be used to achieve a 95% confidence level.
Sampling Method
The sample will be obtained by retrieving the patient’s information from the electronic health records. Elderly patients hospitalized in the health care facility will make the sample.
Inclusion and Exclusion Criteria
The inclusion criteria will include all patients who have had at least two episodes of falls within the hospital. Also, the patients must have been admitted to the hospital for at least one month, ages between 60 and 80 years, and must agree to participate in the study. Exclusion criteria will include all patients who have cognitive impairment and psychiatric conditions that affected rational reasoning (Khoja, 2021). Pediatric patients will be excluded, also, patients who are admitted in less than a month to the commencement of the study will not be included.
Data Collection Procedures
Before the beginning of data collection, the researcher will seek approval from the institutional review board (IRB). Data collection will happen every day using the electronic health and the CEX tool (Dykes et al., 2019). The nurses will record the number of falls per day including the injurious ones and feed the information into the electronic health record system (Dykes et al., 2019). The researcher and the nurse in charge will perform daily random rounds during shifts to audit staff nurses using the handoff CEX audit tool.
Data Collection Measures
The variables will be measured by comparing the post and pre-intervention data. The primary outcome will be the overall rate of patient falls per 1000 patient days. Secondary outcomes include the overall rate of injurious patient falls per 1000 patient days (Khoja, 2021). If the rate of overall patient falls and injurious patient falls are reduced from the baseline, then the intervention is effective (Khoja, 2021). Another secondary outcome will measure (using the CLEX) the consistency of the nurses to use the TIPs.
References
Avanecean, D., Calliste, D., Contreras, T., Lim, Y., & Fitzpatrick, A. (2017). Effectiveness of Patient-Centered Interventions On Falls in The Acute Care Setting Compared to Usual Care: A Systematic Review. JBI Evidence Synthesis, 15(12), 3006-3048. https://doi.org/10.11124/JBISRIR-2016-003331
Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., … & Bates, D. W. (2020). Evaluation of A Patient-Centered Fall-Prevention Tool Kit to Reduce Falls and Injuries: A Nonrandomized Controlled Trial. JAMA network open, 3(11), e2025889-e2025889. https://doi.org/10.1001/jama.2010.1567
Dykes, P. C., Adelman, J. S., Alfieri, L., Bogaisky, M., Carroll, D., Carter, E., … & Spivack, L. B. (2019). The fall TIPS (tailoring interventions for patient safety) program: A collaboration to end the persistent problem of patient Falls. Nurse Leader, 17(4), 365-370. https://www.falltips.org/wp-content/uploads/2019/09/Dykes-2019.pdf
Duckworth, M., Adelman, J., Belategui, K., Feliciano, Z., Jackson, E., Khasnabish, S., … & Dykes, P. C. (2019). Assessing The Effectiveness of Engaging Patients and Their Families in The Three-Step Fall Prevention Process Across Modalities of an Evidence-Based Fall Prevention Toolkit: An Implementation Science Study. Journal of Medical Internet Research, 21(1), e10008. https://www.jmir.org/2019/1/e10008/
Khoja, A. (2021). Implementation of Tailored Interventions for Patient Safety (TIPS) to Reduce Fall Rates (Doctoral dissertation, Grand Canyon University). https://www.proquest.com/docview/2531206918?pqorigsite=gscholar&fromopenview=true
Mayhob, M. M., & Amin, M. A. (2022). Fall Prevention Interventions: Tailored Approach versus Routine Interventions among Elderly Hospitalized Patients. American Journal of Nursing Research, 10(1), 26-33. http://article.scinursingresearch.com/pdf/ajnr-10-1-4.pdf
Appendix
Appendix A
Figure 1: Fall Prevention in Three Steps
Appendix B
Figure 2. The Laminated Paper Fall TIPS Toolkit (English). Color provides clinical decision support to link patient specific fall risk factors to evidence-based interventions.
Appendix C
Figure 3: CEX Assessment Form.