Application of Analytic Methods: Using the Johns Hopkins Nursing Evidence-Based Practice Individual Evidence Summary Tool

The problem of patient safety has received a lot of deserved attention recently. Numerous studies addressing the physical well-being of inpatients have concluded that patient falls pose an immediate threat to patients’ health (Reuben et al., 2017). In their articles, Sujan (2015), Hill et al. (2016), Roman et al. (2016), and Reuben et al. (2017) posit that patient and staff education will reduce the problem of patient falls.

Appraising Qualitative Research

The research designs used in both studies allow determining the nature of the problem of patient safety, in general, and the issue of falls, in particular. Therefore, the selected research designs answer the research questions fully. Since both studies were not restricted to a single healthcare facility, the samples were representative of the selected population and could be described as diverse. However, both studies had several unique limitations.

The use of focus groups in Sujan’s (2015) study could have introduced subjectivity into the obtained data, whereas Hill et al.’s (2016) results may have lost accuracy due to a large time lapse between the trial and interview. Curiously, the described limitations have similar nature despite their differences since both imply the presence of a personal perspective, whether due to the format of data collection or its time-lapse.

Nevertheless, given the evidence summary, each of the research described above qualifies as an important addition to the analysis of patient safety and, specifically, patient falls in the clinical environment. Sujan (2015) and Hill et al. (2016) offer the reader to view the problem of patient falls from different standpoints, one of them promoting staff education and the other insisting on the importance of patient education. Despite minor issues in their research results, both articles serve as decent support for future interventions.

Appraising Quantitative Research

Similar to the two qualitative studies mentioned above, both Roman et al. (2016) and Reuben et al. (2017) answer their respective questions fully. Roman et al. prove that a functional capacity program is a possible solution to the patient fall issue with the help of a randomized clinical trial and a comparison of the results in two groups. In turn, Reuben et al. (2017) use the pre-and post-test approach to evaluate the effects of the STRIDE multifactorial intervention on fall prevention and management. Thus, the choice of the methodology can be deemed legitimate.

The sample sizes were quite representative of the target population, with the use of the random sampling technique as the key approach. Remarkably, random sampling helps to avoid skewed analysis results caused by the possible underrepresentation of some populations. However, the approach used in the studies is quite a time- and resource-consuming, which makes it a very difficult method to use. Thus, the limitations observed in the two articles are linked to the selection of the research strategies significantly, the sampling tool mentioned above being the most evident one.

Nonetheless, the outcomes of the analysis performed by Roman et al. (2016) and Reuben et al. (2017) are equally important for the prevention of falls among inpatients. The research results have contributed to the current discussion vastly with the introduction of innovative fall prevention and management techniques. In addition, the studies under analysis have proven once again that interdisciplinary collaboration between nurses in the clinical context is essential.

The issue of patient falls remains a problem for modern use, yet the integration of patient and nurse education techniques will help to counteract the current situation with fall management. As four studies analyzed above have shown, communication between patients and nurses leads to significant improvements. With the addition of communication tools, the process of fall management will be enhanced extensively, with impressively positive results.

References

Hill, A. M., Waldron, N., Francis-Coad, J., Haines, T., Etherton-Beer, C., Flicker, L.,… McPhail, S. M. (2016). ‘It promoted a positive culture around falls prevention’: staff response to a patient education programme – A qualitative evaluation. BMJ Open, 6(12), 1-8. Web.

Reuben, D. B., Gazarian, P., Alexander, N., Araujo, K., Baker, D., Bean, J. F.,… Leipzig, R. M. (2017). The strategies to reduce injuries and develop confidence in elders intervention: Falls risk factor assessment and management, patient engagement, and nurse co‐management. Journal of the American Geriatrics Society, 65(12), 2733-2739. Web.

Roman, E., García-Galceran, C., Torrades, T., Herrera, S., Marin, A., Donate, M.,… Guarner, C. (2016). Effects of an exercise programme on functional capacity, body composition and risk of falls in patients with cirrhosis: A randomized clinical trial. PLoS One, 11(3), 1-15. Web.

Sujan, M. (2015). An organisation without a memory: A qualitative study of hospital staff perceptions on reporting and organisational learning for patient safety. Reliability Engineering & System Safety, 144, 45-52. Web.

Evidence Summary

Article #	Author & Date	Evidence Type	Sample, Sample Size & Setting	Study findings	Limitations	Evidence Level & Quality
1	Hill et al. (2016)	Focus groups	Convenience, 40, hospital	Positive culture and teamwork reduces the threat of falls	Possible data subjectivity	High
2	Sujan (2015)	Interview	Convenience, 35, hospital	Both patient and nurse education (organizational learning) is needed to address falls	Possible data subjectivity	High
3	Reuben et al. (2017)	Focus groups	Random, 40, hospital	The STRIDE intervention will help to promote fall education	Time and financial resources	High
4	Roman et al. (2016)		Random, 10, hospital	A functional capacity program is likely to reduce the threat of falls	Small sample size	High