HCA 620 Assignment Capstone Project: Preliminary Literature Review and Action Item Checklist

HCA 620 Assignment Capstone Project: Preliminary Literature Review and Action Item Checklist

HCA 620 Assignment Capstone Project: Preliminary Literature Review and Action Item Checklist

Literature that support the proposed research intervention for the evidence-based practice was obtained from the articles researched from credible databases.  Ten articles were included in the appraisal. It is worth noting that there is an acute shortage of evidence on the use of nursing rounds to reduce incidences of falls among hospitalized patients. This can be seen from the fact that a majority of the articles are systematic reviews, with one of them dated back to the year 2006. The appraisal of the research articles showed that there is moderate evidence on the efficacy of using nursing rounds to prevent or reduce prevalence of patient falls. The frequency of nursing rounds that were examined in these articles is hourly nursing rounds. While one article reported nursing rounds to be associated with outcomes that are not statistically significant, the findings have some clinical significance due to the duration of the study and the variables that were under investigation.

Preliminary Literature Review

Mitchell et al., (2014) conducted a systematic review of literature that aimed at investigating the effect of nursing rounds on nursing responsiveness as its research design. The authors searched databases that included EMBASE, CINAHL, and Medline for studies on the topic as their methodology. The outcomes of the review demonstrated that hourly nursing rounds have a significant effect on the satisfaction of patients with care, patient falls, and call light use. While this conclusion has impact on the proposed intervention, this research had low reliability due to the methods that were used. Firstly, the articles that were used in the review had considerable variability in their study protocols. They also had methodological bias, which lowered their significance. However, being among the few studies on the topic, the current study will rely on its conclusions on the efficacy of nursing rounds in preventing patient falls.

Goldsack et al., (2015) conducted a pilot study that aimed at examining the effect of hourly nursing rounds on patient falls. The study was conducted over a 30-day period in two units to determine the impact of the intervention on patient falls. The study utilized the support from nurse leaders, who acted as the champions for the intervention. The study outcomes from this research demonstrated significant efficacies in the use of nursing rounds to prevent or reduce patient falls. According to the outcomes, a decline in the patient fall rate in unit one by 3.9 falls per 1000 patient days was reported. There was also a decline in patient fall rate in the pilot period by 1.3 falls per 1000 patient days, which was lower than the predicted baseline fall rate. The fall rate in the second unit was 2.6 falls in every 1000 patient days.

HCA 620 Assignment Capstone Project Preliminary Literature Review and Action Item Checklist
HCA 620 Assignment Capstone Project Preliminary Literature Review and Action Item Checklist

However, the fall rate during the pilot period was not significant as evidenced by a fall rate of 2.5 falls per 1000 patient days from 2.6 falls per 1000 patient days. Therefore, the authors concluded that the use of nursing rounds is only effective if there is adequate interdisciplinary engagement as seen from the study findings from unit one. The study findings reported by Goldsack et al., (2015) can be relied wholly for this intervention. This can be seen in the reliability and validity of the methods that were used. The study period also allowed for the identification of any effect of intervening factors on the study variables.

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Daniels (2016) conducted a study that aimed at examining the effect of purposeful as well as timely nursing round on patient safety and satisfaction. The intervention was implemented in the clinical setting where nursing rounds were done hourly to promote the outcome measures of the research. The study outcomes revealed that there was doubling of the intervals of nursing rounds during sleeping and awake hours. There was a substantial increase in compliance with the intervention up to 64% from zero. The outcomes included substantial increase in patient toileting by 41%, responsiveness of the staffs by 15% and reduction in patient falls by 50%. Therefore, the researchers recommended the use of purposeful as well as timely nursing rounds to promote patient safety in relation to aspects such as prevention of falls and improvement in staff responsiveness. The outcomes reported by Daniels (2016) in his study can be relied upon in the proposed intervention. This is attributed to the reliability and validity of the methods used in investigating the research topic.

The study conducted by Tucker et al., (2012) aimed at examining the feasibility of using structured nursing rounds interventions in preventing patient falls in practice. The researches utilized a repeated measures design where risk assessment and fall rates data were obtained over 12 week period and one year after the intervention was implemented. The results showed a significant decline in falls per 1000 hospital days with a considerable fall in the scores of mean fall risk assessment. However, these rates returned to baseline after one-year period. Therefore, the authors concluded that while the intervention might prove effective in reducing incidence of falls among patients, models that sustain the use of the intervention should be embraced. This study is associated with significant strengths. It has high research validity since the sample, methods of data collection and analysis, and observational procedures are explicitly explained. Consequently, it forms the basis of the proposed intervention for this evidence-based practice proposal.

The research by Meade, Bursell and Ketelsen (2006) investigated the effect of nursing rounds on patients’ satisfaction, safety, and call light use. The outcomes revealed that nursing rounds performed on specific intervals were associated with significant reduction in rates of patient falls and use of call lights and enhanced patient satisfaction rate. This study is associated with high reliability and validity. The intervention was implemented and its outcomes followed up for some time. The follow up allowed the researchers to explore possible intervening factors that might affect the outcomes of the study. The methods of variable analysis are also adequate as they pointed out the existing relationship with the outcomes of the research. The research by Walsh et al., (2018) showed that the use of multifaceted fall prevention intervention improved the trends of fall rates among hospitalized patients. The multifaceted program, which included the use of nursing rounds, showed that there was significant decline in patients’ falls and injuries due to the use of hourly rounds to mitigate risks of falls. Therefore, based on these sources of evidence, it proves apparent that the use of nursing rounds has enhanced efficacy when compared to call lights in prevention and reduction of falls among hospitalized patients.