I need to review a PICOT STATEMENT.
This is my PICOT statement, i need help to revise it.
In hospitalized adults who are weak and unsteady (P), does patient-centered nursing intervention; doing safety rounds (I)when compared to following own mobility plan of staying active to stay strong (C) leads to zero falls (O) over duration of 6 months (T)?
Criteria Comments: this is the professor comments
Let us work on the PICOT a bit per the feedback provided in Week 3: In hospitalized adults, does implementation of XXX, compared to current practice, impact fall rates in 3 months? What is your intervention? You have included two separate interventions here in the PICOT. Review your literature. What is the most common intervention to decrease falls. Are you planning to complete hourly rounding? You may want to search intentional rounding, scheduled rounding, hourly rounding, etc. If you plan to implement the nursing interventions - you will need to pull literature that is inclusive of the same nursing intervention bundle in ALL literature to decrease falls.
Literature Evaluation Table Dina Day PICOT: In hospitalized adults who are weak and unsteady (P), does patient-centered nursing intervention; doing safety rounds (I)when compared to following own mobility plan of staying active to stay strong (C) leads to zero falls (O) over duration of 6 months (T)? Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article Article Title and Year Published Research Questions/ Hypothesis, and Purpose/Aim of Study Design (Quantitative, Qualitative, or other) Setting/Sample Methods: Intervention/ Instruments Analysis/Data Collection Outcomes/Key Findings Recommendations Explanation of How the Article Supports Your Proposed EBP Practice Project Proposal Lamb, S. E., Bruce, J., Hossain, A., Ji, C., Longo, R., Lall, R., Bojke, C., Hulme, C., Withers, E., Finnegan, S., Sheridan, R., Willett, K., Underwood, M., & Prevention of Fall Injury Trial Study Group The New England journal of medicine, 383(19), 1848–1859. https://doi.org/10.1056/NEJMoa2001500 Screening and Intervention to Prevent Falls and Fractures in Older People. 2020 Determine the rate of fractures per 100 persons in 18 months qualitative 9803 aged above 70 years Targeted exercise and multifactorial intervention questionnaires Selection and directed intervention did not have significant effects on lower fracture rates. RR with MFI fall prevention as likened with advice by mail was 1.30 (95% CI, 0.99 to 1.71) Screening should not be used in place of multifactorial and other interventions This article is essential to the EBP practice due to its examination of the efficacy of screening and interventions in the inhibition of tumbles and fractures in older patients Liu-Ambrose, T., Davis, J. C., Best, J. R., Dian, L., Madden, K., Cook, W., Hsu, C. L., & Khan, K. M. JAMA, 321(21), 2092–2100. https://doi.org/10.1001/jama.2019.5795 Effect of a Home-Based Exercise Program on Subsequent Falls Among Community-Dwelling High-Risk Older Adults After a Fall: A Randomized Clinical Trial. 2019 This study aimed to measure the consequence of a home-based exercise suite as a fall avoidance plan in aged patients Quantitative The intervention group had 173 participants, while the sample size of the control group was 172 A randomized controlled study. Participants were treated to home-based strength and balance retraining program 236 falls occurred in 172 members in the treatment group compared to 366 falls in the control set of 172 participants Home-based strength and balance retraining exercises can be used effectively to reduce falls. This RCT is essential in this practice based on the findings of the effectiveness of home-based exercise in reducing falls in older adults Avanecean, D., Calliste, D., Contreras, T., Lim, Y., & Fitzpatrick, A. JBI Evidence Synthesis, 15(12), 3006-3048. https://journals.lww.com/jbisrir/Fulltext/2017/12000/Effectiveness_of_patient_centered_interventions_on.14.aspx A systematic review is the effectiveness of patient-centered interventions on falls in the acute care setting compared to usual care. 2017 This study aimed to evaluate the efficacy of patient-centered intrusions on tumbles in the critical care location. Quantitative Acute elderly hospital department Standardized critical appraisal data extraction form Meta-analysis Two studies reviewed indicated a p< 0.04="" decrease="" in="" falls.="" two="" other="" researches="" showed="" no="" decline="" in="" falls="" between="" groups="">< 0.5 patient-centered intervention in the acute elderly patient setting should be used instead of usual care this study examines the effectiveness of patient-centered care compared to usual care in preventing falls among older patients. sherrington, c., michaleff, z. a., fairhall, n., paul, s. s., tiedemann, a., whitney, j., cumming, r. g., herbert, r. d., close, j., & lord, s. r. british journal of sports medicine, 51(24), 1750–1758. https://doi.org/10.1136/bjsports-2016-096547 exercise to prevent falls in older adults: an updated systematic review and meta-analysis. 2017 this study aimed to test the effect of workout in averting falls among the elderly quantitative 88 trials reviewed with 19478 participants random-effects meta-analysis and meta-regression systematics review the exercise was established to reduce the rate of falls in older patients in community residences by 21% healthcare professionals should recommend exercise as an intervention to reduce falls among elder patients one of the patient-centered care approaches in designing appropriate exercises to reduce falls among older patients. this research is essential for this ebp approach cheng, p., tan, l., ning, p., li, l., gao, y., wu, y., schwebel, d. c., chu, h., yin, h., & hu, g. international journal of environmental research and public health, 15(3), 498. https://doi.org/10.3390/ijerph15030498 comparative effectiveness of published interventions for elderly fall prevention: a systematic review and network meta-analysis. 2018 to compare then existing interpolation for the inhibition of falls among community-dwelling adults aged above 60 years qualitative 49 trials review involving 27740 participants a systematic review and network metanalysis multifactorial interventions, education, and exercise mfi yielded better results with (or: 0.64, 95% cri: 0.53 to 0.77) education and training yielded (or: 0.65, 95% cri: 0.38 to 1.00) multifactorial interventions should be used together with education and exercise based on the evidence of their effectiveness this analysis is essential for this ebp practice because it compares published interventions for elderly fall prevention morello, r. t., soh, s. e., behm, k., egan, a., ayton, d., hill, k., flicker, l., etherton-beer, c. d., arendts, g., waldron, n., redfern, j., haines, t., lowthian, j., nyman, s. r., cameron, p., fairhall, n., & barker, a. l. injury prevention : journal of the international society for child and adolescent injury prevention, 25(6), 557–564. https://doi.org/10.1136/injuryprev-2019-043214 multifactorial falls prevention programs for older adults presenting to the emergency department with a fall: systematic review and meta-analysis. 2019 the study aimed to conclude whether mfi falls anticipation interventions are operational in the ed among older patients qualitative 12 studies with a total of 3986 participants. articles collected from six different countries systematic review and meta-analysis of rcts mfi meta-analysis of the results indicated no effect on reducing falls among the elderly. (rr = 0.78; 95% ci: 0.58 to 1.05) mfis are not effective for use in ed; nurses should design other practices in the emergency departments this study will help define the effectiveness of mfi in the ed for older patients dykes, p. c., burns, z., adelman, j., benneyan, j., bogaisky, m., carter, e., ergai, a., lindros, m. e., lipsitz, s. r., scanlan, m., shaykevich, s., & bates, d. w. jama network open, 3(11), e2025889. https://doi.org/10.1001/jamanetworkopen.2020.25889 evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial. 2020 the primary aim of this study was to assess the success of falls prevention intervention toolkit in minimizing fall in hospitalized elderly patients qualitative the study used 37231 patients with 17948 before the intervention. a non-randomized controlled trial nurse-led fall prevention toolkit the results indicated an overall 15% decrease in falls after the tumble prevention toolkit was implemented. (2.92 vs 2.49 falls per 1000 patient-days [95% ci, 2.06-3.00 falls per 1000 patient-days] fall prevention toolkits are effective when used on hospitalized patients; patients and their families should be engaged to yield better results this study is essential in this practice because it evaluates the efficacy of falls preventions tool kits in lessening falls in hospitalized older patients sherrington, c., fairhall, n. j., wallbank, g. k., tiedemann, a., michaleff, z. a., howard, k., clemson, l., hopewell, s., & lamb, s. e. the cochrane database of systematic reviews, 1(1), cd012424. https://doi.org/10.1002/14651858.cd012424.pub2 exercise for preventing falls in older people living in the community. 2019 the objectives of this study were to evaluate the impacts, including paybacks and destructions, of exercise interventions for preventing falls in elderly patients in the community settings qualitative 108 rcts were reviewed with a sample size of 23407 in the community setting in 25 different countries. home exercise interventions for the prevention of falls home exercise decreases the amount of tumbles by 23% (rate ratio (rar) 0.77, 95% poise interval (ci) 0.71 to 0.83; 12,981 participants, 59 studies) all elderly patients discharged should be prescribed home exercise to reduce the rate of hospitalization after discharge this studies the reimbursements and harms of workout interventions for the prevention of falls. this will be vital to this ebp practice guirguis-blake, j. m., michael, y. l., perdue, l. a., coppola, e. l., & beil, t. l. jama, 319(16), 1705-1716. https://jamanetwork.com/journals/jama/article-abstract/2678103 interventions to prevent falls in older adults: updated evidence report and systematic review for the us preventive services task force. 2018 the study systematically reviewed the works on the efficacy and problems of fall prevention in adults in community settings. quantitative 62 rcts with a sample size of 35058 participants rcts targeting adults above 65 years and above multifactorial interventions and exercise trials mfi: (incidence rate ratio [irr], 0.79 [95% ci, 0.68-0.91]) exercise trials (relative risk, 0.89 [95% 13 ci, 0.81-0.97]) mfi and exercise trials effectively reduce the probability of an elderly patient falling in the community setting. similar interventions should be initiated when patients are still in hospital settings for this ebp practice, this article will be essential in underlying the usefulness of all interventions to inhibit falls among the aged. naseri, c., haines, t. p., etherton-beer, c., mcphail, s., morris, m. e., flicker, l., ... & hill, a. m. age and ageing, 47(4), 512-519. https://academic.oup.com/ageing/article-abstract/47/4/512/4951828 reducing falls in older adults recently discharged from hospital: a systematic review and meta-analysis. 2018 the main aim of this review article was to synthesize the indication for operative falls deterrence interventions among discharged adult patients qualitative 16 studies 0.5="" patient-centered="" intervention="" in="" the="" acute="" elderly="" patient="" setting="" should="" be="" used="" instead="" of="" usual="" care="" this="" study="" examines="" the="" effectiveness="" of="" patient-centered="" care="" compared="" to="" usual="" care="" in="" preventing="" falls="" among="" older="" patients.="" sherrington,="" c.,="" michaleff,="" z.="" a.,="" fairhall,="" n.,="" paul,="" s.="" s.,="" tiedemann,="" a.,="" whitney,="" j.,="" cumming,="" r.="" g.,="" herbert,="" r.="" d.,="" close,="" j.,="" &="" lord,="" s.="" r.="" british="" journal="" of="" sports="" medicine, 51(24),="" 1750–1758.="" https://doi.org/10.1136/bjsports-2016-096547="" exercise="" to="" prevent="" falls="" in="" older="" adults:="" an="" updated="" systematic="" review="" and="" meta-analysis.="" 2017="" this="" study="" aimed="" to="" test="" the="" effect="" of="" workout="" in="" averting="" falls="" among="" the="" elderly="" quantitative="" 88="" trials="" reviewed="" with="" 19478="" participants="" random-effects="" meta-analysis="" and="" meta-regression="" systematics="" review="" the="" exercise="" was="" established="" to="" reduce="" the="" rate="" of="" falls="" in="" older="" patients="" in="" community="" residences="" by="" 21%="" healthcare="" professionals="" should="" recommend="" exercise="" as="" an="" intervention="" to="" reduce="" falls="" among="" elder="" patients="" one="" of="" the="" patient-centered="" care="" approaches="" in="" designing="" appropriate="" exercises="" to="" reduce="" falls="" among="" older="" patients.="" this="" research="" is="" essential="" for="" this="" ebp="" approach="" cheng,="" p.,="" tan,="" l.,="" ning,="" p.,="" li,="" l.,="" gao,="" y.,="" wu,="" y.,="" schwebel,="" d.="" c.,="" chu,="" h.,="" yin,="" h.,="" &="" hu,="" g.="" international="" journal="" of="" environmental="" research="" and="" public="" health, 15(3),="" 498.="" https://doi.org/10.3390/ijerph15030498="" comparative="" effectiveness="" of="" published="" interventions="" for="" elderly="" fall="" prevention:="" a="" systematic="" review="" and="" network="" meta-analysis.="" 2018="" to="" compare="" then="" existing="" interpolation="" for="" the="" inhibition="" of="" falls="" among="" community-dwelling="" adults="" aged="" above="" 60="" years="" qualitative="" 49="" trials="" review="" involving="" 27740="" participants="" a="" systematic="" review="" and="" network="" metanalysis="" multifactorial="" interventions,="" education,="" and="" exercise="" mfi="" yielded="" better="" results="" with="" (or:="" 0.64,="" 95%="" cri:="" 0.53="" to="" 0.77) ="" education="" and="" training="" yielded="" (or:="" 0.65,="" 95%="" cri:="" 0.38="" to="" 1.00)="" multifactorial="" interventions="" should="" be="" used="" together="" with="" education="" and="" exercise="" based="" on="" the="" evidence="" of="" their="" effectiveness="" this="" analysis="" is="" essential="" for="" this="" ebp="" practice="" because="" it="" compares="" published="" interventions="" for="" elderly="" fall="" prevention="" morello,="" r.="" t.,="" soh,="" s.="" e.,="" behm,="" k.,="" egan,="" a.,="" ayton,="" d.,="" hill,="" k.,="" flicker,="" l.,="" etherton-beer,="" c.="" d.,="" arendts,="" g.,="" waldron,="" n.,="" redfern,="" j.,="" haines,="" t.,="" lowthian,="" j.,="" nyman,="" s.="" r.,="" cameron,="" p.,="" fairhall,="" n.,="" &="" barker,="" a.="" l.="" injury="" prevention="" :="" journal="" of="" the="" international="" society="" for="" child="" and="" adolescent="" injury="" prevention, 25(6),="" 557–564.="" https://doi.org/10.1136/injuryprev-2019-043214="" multifactorial="" falls="" prevention="" programs="" for="" older="" adults="" presenting="" to="" the="" emergency="" department="" with="" a="" fall:="" systematic="" review="" and="" meta-analysis. ="" 2019="" the="" study="" aimed="" to="" conclude="" whether="" mfi="" falls="" anticipation="" interventions="" are="" operational="" in="" the="" ed="" among="" older="" patients="" qualitative="" 12="" studies="" with="" a="" total="" of="" 3986="" participants.="" articles="" collected="" from="" six="" different="" countries="" systematic="" review="" and="" meta-analysis="" of="" rcts="" mfi="" meta-analysis="" of="" the="" results="" indicated="" no="" effect="" on="" reducing="" falls="" among="" the="" elderly.="" (rr="0.78;" 95%="" ci:="" 0.58="" to="" 1.05)="" mfis="" are="" not="" effective="" for="" use="" in="" ed;="" nurses="" should="" design="" other="" practices="" in="" the="" emergency="" departments="" this="" study="" will="" help="" define="" the="" effectiveness="" of="" mfi="" in="" the="" ed="" for="" older="" patients="" dykes,="" p.="" c.,="" burns,="" z.,="" adelman,="" j.,="" benneyan,="" j.,="" bogaisky,="" m.,="" carter,="" e.,="" ergai,="" a.,="" lindros,="" m.="" e.,="" lipsitz,="" s.="" r.,="" scanlan,="" m.,="" shaykevich,="" s.,="" &="" bates,="" d.="" w.="" jama="" network="" open, 3(11),="" e2025889.="" https://doi.org/10.1001/jamanetworkopen.2020.25889="" evaluation="" of="" a="" patient-centered="" fall-prevention="" tool="" kit="" to="" reduce="" falls="" and="" injuries:="" a="" nonrandomized="" controlled="" trial. ="" 2020="" the="" primary="" aim="" of="" this="" study="" was="" to="" assess="" the="" success="" of="" falls="" prevention="" intervention="" toolkit="" in="" minimizing="" fall="" in="" hospitalized="" elderly="" patients="" qualitative="" the="" study="" used="" 37231="" patients="" with="" 17948="" before="" the="" intervention.="" a="" non-randomized="" controlled="" trial="" nurse-led="" fall="" prevention="" toolkit="" the="" results="" indicated="" an="" overall="" 15%="" decrease="" in="" falls="" after="" the="" tumble="" prevention="" toolkit="" was="" implemented.="" (2.92="" vs="" 2.49="" falls="" per="" 1000="" patient-days="" [95%="" ci,="" 2.06-3.00="" falls="" per="" 1000="" patient-days]="" fall="" prevention="" toolkits="" are="" effective="" when="" used="" on="" hospitalized="" patients;="" patients="" and="" their="" families="" should="" be="" engaged="" to="" yield="" better="" results="" this="" study="" is="" essential="" in="" this="" practice="" because="" it="" evaluates="" the="" efficacy="" of="" falls="" preventions="" tool="" kits="" in="" lessening="" falls="" in="" hospitalized="" older="" patients="" sherrington,="" c.,="" fairhall,="" n.="" j.,="" wallbank,="" g.="" k.,="" tiedemann,="" a.,="" michaleff,="" z.="" a.,="" howard,="" k.,="" clemson,="" l.,="" hopewell,="" s.,="" &="" lamb,="" s.="" e.="" the="" cochrane="" database="" of="" systematic="" reviews, 1(1),="" cd012424.="" https://doi.org/10.1002/14651858.cd012424.pub2="" exercise="" for="" preventing="" falls="" in="" older="" people="" living="" in="" the="" community. ="" 2019="" the="" objectives="" of="" this="" study="" were="" to="" evaluate="" the="" impacts,="" including="" paybacks="" and="" destructions,="" of="" exercise="" interventions="" for="" preventing="" falls="" in="" elderly="" patients="" in="" the="" community="" settings="" qualitative="" 108="" rcts="" were="" reviewed="" with="" a="" sample="" size="" of="" 23407="" in="" the="" community="" setting="" in="" 25="" different="" countries.="" home="" exercise="" interventions="" for="" the="" prevention="" of="" falls="" home="" exercise="" decreases="" the="" amount="" of="" tumbles="" by="" 23%="" (rate="" ratio="" (rar)="" 0.77,="" 95%="" poise="" interval="" (ci)="" 0.71="" to="" 0.83;="" 12,981="" participants,="" 59="" studies)="" all="" elderly="" patients="" discharged="" should="" be="" prescribed="" home="" exercise="" to="" reduce="" the="" rate="" of="" hospitalization="" after="" discharge="" this="" studies="" the="" reimbursements="" and="" harms="" of="" workout="" interventions="" for="" the="" prevention="" of="" falls.="" this="" will="" be="" vital="" to="" this="" ebp="" practice="" guirguis-blake,="" j.="" m.,="" michael,="" y.="" l.,="" perdue,="" l.="" a.,="" coppola,="" e.="" l.,="" &="" beil,="" t.="" l.="" jama, 319(16),="" 1705-1716.="" https://jamanetwork.com/journals/jama/article-abstract/2678103="" interventions="" to="" prevent="" falls="" in="" older="" adults:="" updated="" evidence="" report="" and="" systematic="" review="" for="" the="" us="" preventive="" services="" task="" force. ="" 2018="" the="" study="" systematically="" reviewed="" the="" works="" on="" the="" efficacy="" and="" problems="" of="" fall="" prevention="" in="" adults="" in="" community="" settings.="" quantitative="" 62="" rcts="" with="" a="" sample="" size="" of="" 35058="" participants="" rcts="" targeting="" adults="" above="" 65="" years="" and="" above="" multifactorial="" interventions="" and="" exercise="" trials="" mfi:="" (incidence="" rate="" ratio="" [irr],="" 0.79="" [95%="" ci,="" 0.68-0.91])="" exercise="" trials="" (relative="" risk,="" 0.89="" [95%="" 13="" ci,="" 0.81-0.97])="" mfi="" and="" exercise="" trials="" effectively="" reduce="" the="" probability="" of="" an="" elderly="" patient="" falling="" in="" the="" community="" setting.="" similar="" interventions="" should="" be="" initiated="" when="" patients="" are="" still="" in="" hospital="" settings="" for="" this="" ebp="" practice,="" this="" article="" will="" be="" essential="" in="" underlying="" the="" usefulness="" of="" all="" interventions="" to="" inhibit="" falls="" among="" the="" aged.="" naseri,="" c.,="" haines,="" t.="" p.,="" etherton-beer,="" c.,="" mcphail,="" s.,="" morris,="" m.="" e.,="" flicker,="" l.,="" ...="" &="" hill,="" a.="" m.="" age="" and="" ageing, 47(4),="" 512-519.="" https://academic.oup.com/ageing/article-abstract/47/4/512/4951828="" reducing="" falls="" in="" older="" adults="" recently="" discharged="" from="" hospital:="" a="" systematic="" review="" and="" meta-analysis. ="" 2018="" the="" main="" aim="" of="" this="" review="" article="" was="" to="" synthesize="" the="" indication="" for="" operative="" falls="" deterrence="" interventions="" among="" discharged="" adult="" patients="" qualitative="" 16="">