Module 5 Discussion: ROL Synthesis of Findings

 PROMPT

In this DB, you will synthesize the four research articles about your topic discussed in Modules 1 & 2. A synthesis includes an analysis of the aggregate of articles, not the individual articles. e.g. clustering and interrelating ideas from the studies to form an overall representation of the conceptual definitions, descriptions, interventions, instruments, and strengths and weaknesses of the body of knowledge represented by the articles. See the examples in Chapter 7 (in particular, Synthesizing Sources and Discussion of Empirical Literature) and Chapter 18 related to Quantitative Research in Gray, Grove, & Sutherland (2017). This is a discussion, not a paper! Be succinct and refer to the questions below.

Use the following questions to synthesize your four articles:

1. What are the conclusions drawn from the articles in relation to your topic?

2.  Identify similarities and differences of the studies. These may include a discussion of the samples, research designs, and findings, for example. 

3.  Are there conflicting findings among the articles? 

 GUIDELINES

To receive full credit, your original post should include all elements requested in the prompt (prompt may have multiple parts and/or require an article to be attached). There are no responses required for this assignment, but you are able to respond.

Your online participation grade for this week has two parts: 80% for the post, and 20% APA. 

Sample Assignment

Introduction

1. What are the conclusions drawn from the articles about your topic?

In the article by Shorr et al., (2011) titled, ‘Effects of an Intervention to Increase Bed Alarm Use to Prevent Falls in Hospitalized Patients’   authors were able to conclude that there are several interventions towards to prevention of patient falls in hospital. The use of alarm has been investigated in the article where the author concluded that bedside alarms in nursing units did not provide enough evidence related to fall events.  This means that the use of bedside alarm can be more effective in helping patients with physical restraint than only relying on the nurse or the caregiver present in the ward. Despite the study not aiming at tracking the alarm related expenses and the cost of replacement cords, there were those substantial costs that included disposable sensor pads at $23 and replacement cords at $350. There were also facilities related to expenses of using an alarm to prevent patient falls, maintenance and inventory control.  However, the author still concluded that bed alarms do not necessarily prove to provide an impact concerning fall prevention programs in the hospitals, meaning that this should be implemented keeping in mind the cost-effectiveness of such programs 

Also Karlin & Schoenecker, (n.d.) in an article ‘Effectiveness of Bed Alarms on Falls’   looked at the effectiveness of the bed alarm especially for those taking care of patients in a long term care facility and how this is going to influence the need to conduct further interventions that can help in the reduction of the risks of patient falls and increase the safety of patients. From the articles, the author concludes that it is possible to have a significant statistical difference in the use of bed alarms to prevent patient falls compared to not using them.  

Also, Moses (2016) in the paper titled, ‘’The utilization of an alarm elimination fall prevention program’, the author argues that the need for an Alarm elimination and prevention of patient falls is a growing concern among health facilities with an effort to improve patient care.  The author who utilized the PDCA model ant Kurt Lewin’s Change theory agrees that it is important to come up with the right measurements to determine the effectiveness of this approach.  From the author's conclusion, it will be important for hospitals to mobilize more support from the administration and the upper management in assisting its staff to realize the importance while also looking at the alarm use as more workload in the hospitals. The implementation of alarms calls for a team approach from everyone within the healthcare facility and need to ensure that all nurses can comply with this approach to determine effectiveness.  From the study, the author also finds it important to follow up on the program and ensure that it is implemented in consideration of the nursing staff ratios. This can be realized only when there is proper monitoring of the alarm program for a number of months to be able to discover the major significance that the program can implement as part of the compliance rates.  The author also looked at the impact that the alarm program is bound to have on the staff in general by concluding that the administration and staff where questions related to patient care should also be adjusted to fit alarms in regard to the prevention of patient falls.  

Jorgensen et al., ( 2015) in the article, 'Nationwide time trends and risk factors for in-hospital falls-related major injuries' a study that was conducted in Denmark,  the author concluded that patient falls was a major contributor to major injuries especially for patients aged 65-74 years and those above 75 years. From this study, the authors felt it necessary to put more measures in preventing patient falls. Among the conditions that the study focussed on was depression, osteoporosis, stroke, Parkinson's disease and chronic obstructive pulmonary diseases which are also related to falls and major injuries.  For this conclusion, it is evident that the author advocate for alarm as an intervention to the prevention of patient falls, especially for patients admitted to the hospitals with chronic conditions.

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2. Identify similarities and differences in the studies. These may include a discussion of the samples, research designs, and findings, for example.

It is evident that the four articles agree with the global studies in regard to patient falls. Studies indicate that falls among inpatients is often reported safety incident all over the world. In most of the studies that the authors have covered, there is an average of about 6.63 falls per 1000 occupied bed days. This means that there will be more than 1700 falls each year in relation to an 800-bed capacity.   Another similarity of the articles is that almost more than half of patient falls are responsible for the physical injuries and fractures for a patient admitted in the hospitals. In most cases, as discussed in the articles, falls does not only look at the injury but also the harm that this can cause to the patient, the nursing staff and carers. Falls can also lead to prolonged stay, arouse carer and patient complaints, guilt, litigation, and dissatisfaction.  In most cases, these falls are not usually accidents but could be prevented.

The difference in the articles comes with the determinants of patient falls, for example, age factor in some of the articles was not the problem however falls is contributed by different factors some of which are intrinsic and other are extrinsic (looking at the environmental influences) all these are risk factors that should be looked in to in regard to preventing patient falls. Also, other factors are related to the patient himself and how well they practice self-care which is a very essential factor in regard to recovery behavior.  The other differences come with the impact of alarm intervention wherein one of the articles was not the only determining factor in preventing falls. It is also important that the cost of alarm interventions is calculated to gauge relevance.  

3.  Are there conflicting findings among the articles?

The conflicting findings in the articles are on the age factor and the impact it has on patient falls. In most cases, it is not only the age that determines patient falls in the hospitals since one of the articles also looked at factors such as the environmental infrastructure of the hospital, patient spaces, and organization of nursing schedules. Also, one article did not find the effectiveness of alarm as an intervention to prevent patient falls as effective. This is because there is evidence of other factors leading to falls for which bedside alarm may not prevent.  Overall however the articles agree on the fact that bedside alarms can be one of the interventions, but this should work well with the assistance of the nurse in charge and the carer. 

References

Jorgensen, T. S., Hansen, A. H., Sahlberg, M., Gislason, G. H., Torp-Pedersen, C., Andersson, C., & Holm, E. (2015). Nationwide time trends and risk factors for in-hospital falls-related major injuries. International Journal of Clinical Practice, 69(6), 703-709. doi:10.1111/ijcp.12624

Karlin, M., & Schoenecker, J. (n.d.). Effectiveness of Bed Alarms on fall (Unpublished doctoral dissertation). Fort Hays State University.

Moses, A. (2016). The utilization of an alarm elimination fall prevention program (Doctoral dissertation, Capella University). 

Shorr, R. I., Chandler, A. M., Mion, L. C., Waters, T. M., Liu, M., Daniels, M. J., Miller, S. T. (2012). Effects of an Intervention to Increase Bed Alarm Use to Prevent Falls in Hospitalized Patients. Annals of Internal Medicine, 157(10), 692. Doi: 10.7326/0003-4819-157-10-201211200-00005