Literature Review 

While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone change proposal project, the literature review enables students to map out and move into the active planning and development stages of the project.

A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Statement Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the following sections:

1. Title page
2. Introduction section
3. A comparison of research questions
4. A comparison of sample populations
5. A comparison of the limitations of the study
6. A conclusion section, incorporating recommendations for further research

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Rubic_Print_

Format

20.0%

20.0%

10.0%

5.0%

5.0%

5.0%

Format 5.0%

Course Code	Class Code	Assignment Title	Total Points
NRS-490	NRS-490-O504	Literature Review	100.0
Criteria	Percentage	Unsatisfactory (0.00%)	Less than Satisfactory (75.00%)	Satisfactory (79.00%)	Good (89.00%)	Excellent (100.00%)	Comments	Points Earned
Content	80.0%
Introduction		10.0%	An introduction is not present.	An introduction is present, but it does not relate to the body of the paper.	An introduction is present, and it relates to the body of the paper. There is nothing in the introduction to entice the reader to continue reading.	An introduction is present, and it relates to the body of the paper. Information presented in the introduction provides incentive for the reader to continue reading.	An introduction is present, and it relates to the body of the paper. Information presented in the introduction is intriguing and encourages the reader to continue reading.
Comparison of Research Questions			20.0%	No comparison of research questions is presented.	A comparison of research questions is presented, but it is not valid.	A cursory though valid comparison of research questions is presented.	A moderately thorough and valid comparison of research questions is presented.	A reflective and insightful comparison of research questions is presented.
Comparison of Sample Populations	No comparison of sample populations is presented.	A comparison of sample populations is presented, but it is not valid.	A cursory though valid comparison of sample populations is presented.	A moderately thorough and valid comparison of sample populations is presented.	A reflective and insightful comparison of sample populations is presented.
Comparison of the Limitations of the Study	No comparison of the limitations of the study is presented.	A comparison of the limitations of the study is presented, but it is not valid.	A cursory though valid comparison of the limitations of the study is presented.	A moderately thorough and valid comparison of the limitations of the study is presented.	A reflective and insightful comparison of the limitations of the study is presented.
Conclusion and Recommendations for Further Research	No conclusion and recommendations for further research are presented.	A conclusion and recommendations for further research are presented, but they are not valid.	A conclusion and recommendations for further research are valid, but they are cursory.	A conclusion and recommendations for further research are valid and moderately thorough.	A conclusion and recommendations for further research are reflective and insightful.
Organization and Effectiveness	1				5.0%
Thesis Development and Purpose	Paper lacks any discernible overall purpose or organizing claim.	Thesis is insufficiently developed or vague. Purpose is not clear.	Thesis is apparent and appropriate to purpose.	Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.	Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
Argument Logic and Construction	Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.	Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.	Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.	Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.	Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
Mechanics of Writing (includes spelling, punctuation, grammar, language use)	Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.	Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.	Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.	Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.	Writer is clearly in command of standard, written, academic English.
Paper Format (use of appropriate style for the major and assignment)	2.0%	Template is not used appropriately or documentation format is rarely followed correctly.	Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.	Template is used, and formatting is correct, although some minor errors may be present.	Template is fully used; There are virtually no errors in formatting style.	All format elements are correct.
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)	3.0%	Sources are not documented.	Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.	Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.	Sources are documented, as appropriate to assignment and style, and format is mostly correct.	Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
Total Weightage	100%

Running Head: PROFESSIONAL CAPSTONE AND PRACTICUM
1

PROFESSIONAL CAPSTONE AND PRACTICUM
3

Literature Evaluation Table

Student Name:

Change Topic (2-3 sentences): Awareness creation to increase the number and skills of healthcare providers with the aim of reducing or preventing falls and their related injuries.

Literature review

	Criteria	Article 1	Article 2	Article 3	Article 4
	Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article	Natalie Callis, Applied nursing research link: https://www.sciencedirect.com/science/article/pii/S0897189715001056	Guirguis-Blake, J. M., Michael, Y. L., Perdue, L. A., Coppola, E. L., & Beil, T. L. Link: https://jamanetwork.com/journals/jama/article-abstract/2678103	Joseph, A., Henriksen, K., & Malone, E. (2018). Health Affairs. Link: https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2018.0643	Shaw & Kiegaldie,
	Article Title and Year Published	Falls prevention: Identification of predictive fall risk factors, (2016)	Interventions to Prevent Falls in Older Adults. Updated Evidence Report and Systematic Review for the US Preventive Services Task Force (2018)	The Architecture Of Safety: An Emerging Priority For Improving Patient Safety (2018)	Educating hospital patients to prevent falls: protocol for a scoping review (2019)
Research Questions ( Qualitative )/Hypothesis (Quantitative), : and Purposes/Aim of Study	Provide a comprehensive literature review in an attempt to synthesize research evidence regarding the risk factors that contribute to patient falls in healthcare facilities.	To systematically review the literature regarding the effectiveness and harms of fall prevention interventions in community-dwelling older adults to inform the US Preventive Services Task Force.	The goal of the study is to summarize the key findings linking safety outcomes, healthcare falls and infection, injuries and medical errors. In addition, the article reviews facility designs, legislation in safety and quality improvement and the role of the different stakeholders in healthcare.	To explore the implementation of patient education in reducing falls as captured in research. This includes the content of patient education, the education design and the outcomes or results of patient education.
	Design (Type of Quantitative, or Type of Qualitative)	Qualitative	Qualitative and quantitative	Narrative review		Systematic review
	Setting/Sample	Review of existing documentation	Randomized clinical trials of interventions to prevent falls in community-dwelling adults 65 years and older.	Review of existing documentation. 45 publications reviewed	PubMed, CINAHL, Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine Database, PsychINFO, Education Resources Information Center. 34 publications reviewed
	Methods: Intervention/Instruments		Literature review		Literature review, Randomized clinical trials	Literature review. Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR)
	Analysis	Descriptive analysis	Random-effects meta-analysis and independent review by two reviewers.	Content analysis	Narrative analysis, thematic analysis.
	Key Findings	Communication failure, insufficient orientation and supervision, poor leadership and failure to observe safety protocols or procedure present patients with heightened risks for falling	Awareness and exercise trials had a significant reduction in the number of falls.	Education healthcare providers and creating sufficient support for relatives significantly reduce falls and their associated injuries.	There is a positive association between patient education and reduction in falls.
	Recommendations	Need to train both healthcare givers on the risk factors of falls including psychological changes and organizational physical infrastructure.	Development of projects geared towards Increasing awareness and exercise to reduce the number of falls.	Need to increase research on falls and patient safety beyond inpatient to outpatient and long-time care.	There is a need for further research regarding the design of patient education.
Explanation of How the Article Supports EBP/Capstone Project	Provides an analysis of the potential risk factors which is useful in developing EBP interventions	The article provides important insights into the effectiveness of interventions aimed at reducing falls.	The article provides evidence from numerous sources with a focus on EBP projects hence rich in insights on EBP	The review maps the key elements regarding effective education of patient to prevent falls and provide insights on educational interventions that can help patients mitigate falling within hospitals

Criteria

Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

Article Title and Year Published

Design (Type of Quantitative, or Type of Qualitative)

Systematic review

Setting/Sample

Methods: Intervention/Instruments

Literature review, Randomized clinical trials

Analysis

Key Findings

Recommendations

Article 5	Article 6	Article 7	Article 8
Tricco, Thomas, Veroniki, Hamid, Cogo, Strifler & Riva, (2017). https://jamanetwork.com/journals/jama/article-abstract/2661578	Vlaeyen, Stas, Leysens, Van der Elst, Janssens, Dejaeger, & Milisen, International journal of nursing studies: https://www.sciencedirect.com/science/article/abs/pii/S0020748917300305	Cameron, Dyer, Panagoda, Murray, Hill, Cumming & Kerse. Cochrane database of systematic reviews. Link: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005465.pub4/abstract	Robalino, S., Nyakang’o, S. B., Beyer, F. R., Fox, C., & Allan, L. M. (2018) Systematic reviews Link: https://link.springer.com/article/10.1186/s13643-018-0697-6
Comparisons of interventions for preventing falls in older adults: a systematic review and meta-analysis. (2017)	Implementation of fall prevention in residential care facilities: A systematic review of barriers and facilitators. (2017)	Interventions for preventing falls in older people in care facilities and hospitals. (2018)	Effectiveness of interventions aimed at improving physical and psychological outcomes of fall-related injuries in people with dementia: a narrative systematic review (2018)
Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study	Assessing the potential effectiveness of the interventions used in reducing falls. What types of fall-prevention programs may be effective for reducing injurious falls in older people?	To identify the facilitators and barriers to fall prevention interventions in residential care facilities	To conduct an assessment of the interventions designed to reduce fall incidences among older people in hospitals and care facilities.	Assessing the effectiveness of interventions for improving the psychological and physical wellbeing of people suffering from dementia and who have sustained an injury due to falling
A systematic review, meta-analysis	Quantitative Systematic review	Quantitative Systematic review
54 publications and 41596	Five databases (MEDLINE, EMBASE, CINAHL, PsycINFO, and Web of Science	Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (August 2017); Cochrane Central Register of Controlled Trials (2017, Issue 8); and MEDLINE, Embase, CINAHL and trial registers to August 2017. Recorded 95 trials (138,164 participants),	MEDLINE, CENTRAL, Health Management Information Consortium, EMBASE, CINAHL, Web of Science, Allied and Complementary Medicine Database, and Physiotherapy Evidence Database (PEDro). Hospital wards
Literature review. Randomized clinical trials	Two independent reviewers. Mixed-Method Appraisal Tool for quality appraisal.	Bespoke excel use in data extraction. Independent literature review. Cochrane risk of bias tool
Network meta-analysis, pair-meta analysis and independent review	Thematic and descriptive analysis	Thematic and descriptive analysis, GRADE used to assess the quality of data	Narrative synthesis, Thematic analysis.
Increasing awareness, clinical quality-level improvement and exercise result in reduced falls.	Improved communication, physical infrastructure, awareness and adequate training facilitate EBP while staff shortage, huge workloads, skill deficiency and stress act as barriers.	There is inadequate support to show that vitamin D supplementation, exercises and multifactorial interventions had any impact on reducing falls	There was a high variability bin the outcomes of the studies due to focus on specific areas leading to a huge heterogeneity
The values of caregivers and patients influence the choice and preference for intervention. There is a need for additional research on the same.	Need to consider organizational and local factors such as the social factors that influence the behaviour of individuals within a community when designing an EBP project	There is a need to develop strategies that address both the risk of falling and provide interventions to reduce the number of people who fall.	Need for studies that allow for a meta-analysis by ensuring reduced heterogeneity of the selected studies.
Explanation of How the Article Supports EBP/Capstone	Provides evidence regarding the potential for EBP projects to succeed based on a detailed review.	The study provides a wide list of the potential facilitators and barriers to the EBP project	The study analyses the evidence-based strategies that have been used in the past and their effectiveness in reducing falls.	The article provides evidence regarding the performance of intervention programs which is crucial to the EBP study.

References

Callis, N. (2016). Falls prevention: Identification of predictive fall risk factors. Applied nursing research, 29, 53-58.

Cameron, I. D., Dyer, S. M., Panagoda, C. E., Murray, G. R., Hill, K. D., Cumming, R. G., & Kerse, N. (2018). Interventions for preventing falls in older people in care facilities and hospitals. Cochrane database of systematic reviews, (9).

Guirguis-Blake, J. M., Michael, Y. L., Perdue, L. A., Coppola, E. L., & Beil, T. L. (2018). Interventions to prevent falls in older adults: updated evidence report and systematic review for the US Preventive Services Task Force. Jama, 319(16), 1705-1716.

Joseph, A., Henriksen, K., & Malone, E. (2018). The architecture of safety: An emerging priority for improving patient safety. Health Affairs, 37(11), 1884-1891.

Robalino, S., Nyakang’o, S. B., Beyer, F. R., Fox, C., & Allan, L. M. (2018). Effectiveness of interventions aimed at improving physical and psychological outcomes of fall-related injuries in people with dementia: a narrative systematic review. Systematic reviews, 7(1), 31.

Shaw, L., & Kiegaldie, D. (2019). Educating hospital patients to prevent falls: protocol for a scoping review.

Tricco, A. C., Thomas, S. M., Veroniki, A. A., Hamid, J. S., Cogo, E., Strifler, L., … & Riva, J. J. (2017). Comparisons of interventions for preventing falls in older adults: a systematic review and meta-analysis. Jama, 318(17), 1687-1699.

Vlaeyen, E., Stas, J., Leysens, G., Van der Elst, E., Janssens, E., Dejaeger, E., … & Milisen, K. (2017). Implementation of fall prevention in residential care facilities: A systematic review of barriers and facilitators. International journal of nursing studies, 70, 110-121.

© 2015. Grand Canyon University. All Rights Reserved.

© 2017. Grand Canyon University. All Rights Reserved.

Running head: PROFESSIONAL CAPSTONE AND PRACTICUM 1

PROFESSIONAL CAPSTONE AND PRACTICUM 5

Falls and Related Injuries

Nanah Kamara

GCU

Falls and Related Injuries

Nurses, being the initial contacts for patients in any most health facilities and the fact they interact or engage with patients more when compared to other providers of care constitute a critical component of the healthcare system. Consequently, nurses play a much huge role in making sure that the healthcare system provides not only safe care but also and care of high standard or quality (Sato, Hase, Osaka, Sairyo & Katoh, 2018). However one of the major healthcare or nursing issue over the years is the fall and associated injuries which have proved not only difficult for healthcare providers and facility to manage.

For instance, and according to DuPree, Fritz-Campiz & Musheno, (2014), Unintentional falls constitute the highest cause of non-fatal injuries among people over 65 years in the US. Moreover, one in every three individuals above 65 years falls at least one time in a given year. In addition, injuries from falls cause the highest number of accidental deaths among people 65-year-old and above (Tricco, Thomas, Veroniki, Hamid, Cogo, Strifler & Riva, 2017). Such statistics coupled with the extent of the costs associated with fall call for proper intervention to reduce falls and their associated injuries. For instance, the government spends billions of dollars on fall and their associated injuries on treating falls. The prevention of fall would provide increased funds for investment in other social programs aimed at improving both healthcare and addressing social or communal problems (Zakrajsek, Schuster, Wells, Williams & Silverchanz, 2018).

In addition, falls and their related injuries are responsible for almost 15% of the recorded hospitalization. This increases the burden of healthcare providers especially given the numerous stressors like staff shortage, huge workloads, leadership problems and personal factors among others. An increase in falls and associated injury, therefore, is detrimental to the provision of quality care as captured under the healthy 2020 program goal of reducing deaths that result from falls.

Despite this falls are very complex and difficult to manage or prevent. Given the implications that falls bear on the patients, the healthcare providers and the healthcare system as a whole (Joseph, Henriksen & Malone, 2018), there has been increased There has been an increased research focus towards fall prevention and reduction strategies. As a result, there exist a significant amount of literature regarding the reduction and prevention of falls. However, the literature regarding the topic I inconclusive and hence makes the study both significant and relevant.

Given the background to the association between falls, their associated injuries and improved nursing, this study seeks to explore whether indeed whether awareness creation regarding falls and the available strategies can improve the practice of nursing and consequently better healthcare provision and patient outcomes. To achieve this, the study will be developed using the procedures of evidence-based solutions which involve problem identification, data collection, data analysis and report writing. The PICOT question for the study was whether the creating of awareness regarding safety measures, tools and systems and policies among nurses reduces the prevalence of falls and the related injuries.

The preceding section provides a breakdown of the components in the PICOT question for the study.

P: P or in the population for the study will be nurses

I: Intervention- the development and implementation of an awareness program for nurses.

C: Comparison- Nurses who do not go through the awareness programs.

O: Outcome- Reduced falls, Increased awareness among nurses.

T: Time- 6 months

In conducting the study, a literature review of available documentation regarding awareness creation and hospital falls was carried out with a focus on obtaining data to answer the PICOT question. To ensure that the information collected was not only valid but also accurate, relevant and reliable all sources selected for the study had to have been peer-reviewed. In addition, the sources had to have been developed recently to provide information that was up to date.

References

DuPree, E., Fritz-Campiz, A., & Musheno, D. (2014). A new approach to preventing falls with injuries. Journal of nursing care quality, 29(2), 99-102.

Guirguis-Blake, J. M., Michael, Y. L., Perdue, L. A., Coppola, E. L., & Beil, T. L. (2018). Interventions to prevent falls in older adults: updated evidence report and systematic review for the US Preventive Services Task Force. Jama, 319(16), 1705-1716.

Joseph, A., Henriksen, K., & Malone, E. (2018). The architecture of safety: An emerging priority for improving patient safety. Health Affairs, 37(11), 1884-1891.

Sato, N., Hase, N., Osaka, A., Sairyo, K., & Katoh, S. (2018). Falls among Hospitalized Patients in an Acute Care Hospital: Analyses of Incident Reports. The Journal of Medical Investigation, 65(1.2), 81-84.

Tricco, A. C., Thomas, S. M., Veroniki, A. A., Hamid, J. S., Cogo, E., Strifler, L., … & Riva, J. J. (2017). Comparisons of interventions for preventing falls in older adults: a systematic review and meta-analysis. Jama, 318(17), 1687-1699.

Zakrajsek, A., Schuster, E., Wells, C., Williams, J., & Silverchanz, P. (2018). CAREGIVERS OF OLDER ADULTS DURING CARE TRANSITIONS: INSIGHTS INTO POSITIVE ASPECTS OF CAREGIVING. Innovation in Aging, 2(suppl_1), 896-896.