EBP Assignment: Risk of Falls in Elderly & Hospital Infections

This assignment delves into evidence-based nursing practice, addressing two key clinical questions: the effect of exercise on reducing falls in the elderly and the impact of hand hygiene on preventing hospital-acquired infections. The assignment begins with an introduction to the importance of evidence-based practice (EBP) in healthcare, emphasizing the need for nurses to continually update their knowledge and critically appraise research literature. It outlines the five steps of the EBP process and explains the use of the PICO framework for formulating answerable clinical questions. The assignment then presents two research questions, one on falls and the other on hand hygiene, and details the search strategies employed, including keywords, Boolean operators, and relevant databases such as PubMed and SAGE. The assignment includes PRISMA flowcharts to illustrate the selection process of articles. The first question focuses on the effect of exercise on reducing falls in elderly people, and the second question examines the effect of correct hand hygiene procedures on reducing the risk of hospital-acquired infections. The assignment provides a detailed overview of the research process, from identifying the issue to searching databases, screening articles, determining eligibility, and including the final articles. The assignment also provides details about the databases and key terms used during the research process.

Running heads: EVIDENCE-BASED NURSING RESEARCH
EVIDENCE BASED NURSING RESEARCH
Name of the Student
Name of the University
Author note

1EVIDEMNCE-BASED NURSING RESEARCH
Table of Contents
Introduction......................................................................................................................................3
The EBP process..............................................................................................................................4
PICO format.....................................................................................................................................5
Question 1........................................................................................................................................5
Question 2........................................................................................................................................9
Reference.......................................................................................................................................14

2EVIDEMNCE-BASED NURSING RESEARCH
Introduction
The goal of the professionals of healthcare is providing the patients with safe and
effective care. To adjust with the changes of the healthcare industry, the healthcare professionals
of the regularly need to update their skills and knowledge. In order to understand the research
literatures the healthcare professionals need to relate and evaluate the evidence-based practice.
The healthcare professionals need to critically appraise the literatures learn about the best
practices. Fall is considered as an in activity or lose of self-control which lead the person to rest
without his own will. The evidence practice is a process of five steps which is used by the nurses
for analyzing, evaluating and providing effective care to the patients. The nurses must have
knowledge about the five steps of the evidence based practice which includes asking a question,
accessing evidence to answer the questions, critically appraise the gathered information, apply
the evidences and evaluate the outcomes. The nurses use the PICO framework to assist the
patients in developing questions and answers for providing the patient with an effective
treatment. Another research strategy has been developed using the PRISMA flowchart to search
the relevant literature systematically
Keywords
Falls and elderly persons
Elderly persons and fall prevalence
Weigh exercise and multiple training.
Risk factors of fall or fall
Exercises for falls or fall

3EVIDEMNCE-BASED NURSING RESEARCH
The EBP process
The evidence-based practice can be define as the inclusion of accessible studies, certain
clinical knowledge, and the expectations of the patients to individualize the nursing care. The
placement of then nurses are accurately done on the adopters and promoters, leading to the
enhanced quality and the safety practices. The processes are applied to identify the risk factors of
any issue by collecting accurate evidences from the current literature. It is them followed by
critical appraisal of the identified issues and the evidences from the relevant literature. The last
step of the process is the evaluation of the interventions which are used by the nurses to improve
the health of the people. The nurse should prepare an answerable questions and led the outcomes
step by step by in relieving the patient from the severe effects. It has been proved experimentally
that the use of the evidence practices has improve the health o he clinical practices. The critical
review of the nursing interventions help the nurses in analyzing the success and the failures of
the interventions on the patient before the assessments of the patients with the strategies of the
nursing care. The strategies are described below:
 Ask- Identifying a nursing issue.
 Attain- Reviewing the literature of review of the identified issues.
 Appraise- Critically appraising the collected evidences.
 Apply- Evaluating the requirements of theof the changes regarding the issues.
 Assessing – Evaluating the outcome of the changes in the interventions and the steps
followed in the assessment of the patient.

4EVIDEMNCE-BASED NURSING RESEARCH
PICO format
The PICO/PIO format is used by the nurses for breaking an answerable question into
fragments so that the interventions, outcomes and the comparisons of the steps can be assessed
and analyzed easily. The first step of the PICO format is to do the analyzed of the P component,
i.e. the patients, people, and population whoever is covered. The second step is the step of
intervention do the identification of the potential interventions involved in the questions. The
comparison component identifies the comparisons of the interventions. The last step is the
outcomes of the mentioned questions which is relevant to the identified issues.
PICO framework Questions
P ( patients, population or problems) The elderly persons
I (interventions) Adequate exercises
C (Comparisons) No exercises
O ( Outcomes) Reduction in the risk of falls
Question 1
What is the effect of using exercises to reduce the risk of falls in the elderly people?
The search strategy has been planned using the keywords, Boolean operators and the
relevant databases searching tools for effectively planning and conducting he researches. The
key words are the search elements which targets the web traffic towards the researches. The key
words are the specific words which are related with the topics. The keywords of the research
topic are the effects of the exercise on risk factors of falls in the elderly persons are the exercises,
risk factors, fall, reduced prevalence and elderly people. The usage of Boolean operators in the

5EVIDEMNCE-BASED NURSING RESEARCH
research is to connect and define the relation of the search terms or the key words in the
database. The Boolean operators which are used in the research works are AND, NOT and OR.
Here AND denotes the joining of the two terms. An example – Elderly persons mad falls. OR is
used to connect the different synonyms for broadening the search strategy. Example- Fall or the
risks of fall. NOT is used for excluding a specific term which is not desired, an example of a
sentence using not is ‘fall not dementia’. The database is the collection of several information
and data on a particular topic and the assessment of the database is done by several searching
tools like PubMed and SAGE.
CINAHL: It includes literature/journal articles related to the healthcare and nursing
PubMed: MEDLINE via PubMed@UIC is to evaluate journal articles, books and databases
significant to life sciences SAGE Research methods: It covers the information about 120,000
pages of journals, and SAGE books

6EVIDEMNCE-BASED NURSING RESEARCH
PRISMA Flow
chart
Research identified through
searching the databases (N=40)
Id
en
ti Additional articles recognized
through other sources (N=20)
Records after eradicating the duplicates
(n = 35)
Sc
re
en
Articles included (n=20)
(n = )
Screened articles (n= 30)
(n = )
Eli
gib
ilit Full-text included articles
(n = 10)
Full-text articles under
screening (n= 20)
Key terms searched in the nursing database
P (Patient/ Problem/Population)(University of
buffalo, 2017)
=Risk of falls in elderly people
Falls AND Elderly people [PubMed]
Falls AND Elderly people [SAGE Research
methods]
Elderly people AND fall prevalence[PubMed]
Elderly people AND fall prevalence [SAGE
Research methods]
I (intervention)(University of buffalo, 2017)
= Exercise
Exercises for falls OR Fall AND elderly
people [PubMed]
[SAGE Exercises for falls OR Fall AND
elderly people Research methods]
Multimodal training AND weigh exercise
[PubMed]
Multimodal training AND weigh exercise
[SAGE Research methods]

7EVIDEMNCE-BASED NURSING RESEARCH
In
cl Studies included in
qualitative synthesis
(n = 10)

8EVIDEMNCE-BASED NURSING RESEARCH
Identification
Totally 60 articles were found from the two credential databases sources of nursing and other
additional database search tools. The nursing database which were used in the research are
PubMed and SAGE research methods.
Screening
The total number of journal articles that were assessed were 35. Out of all those articles 30
articles were examined and screened by using the criteria of inclusion and exclusion of selection
of data and out of them 20 articles were selected.
Eligibility
The number of full text articles that were examine by using the inclusion criteria were 0.
Included
Finally a total of 10 articles were selected for conducting the research. Further a quantitative
research was conducted by using the secondary data analysis method for analyzing the role of the
exercises for the reduction of the risk factors of fall among he elderly persons.
Question 2
What is the effect of using correct hand hygiene procedures to reduce the risk of hospital
acquired infections in patients?
Nosocomial infections or the hospital acquired infections has become one of the
important issues in hospitals as people rather than getting cured are acquiring more infections
after being admitted to the hospital (Hagel et al., 2015). Hand hygiene is one of the safety goals
of the patients. In order ensure that whether the hand hygiene is a part of daily procedures or not,

9EVIDEMNCE-BASED NURSING RESEARCH
the healthcare settings need to include certain rules in their hospitals to support the compliance
(Wetzker et al., 2016). The intervention that has been included is ‘the correct hand hygiene
procedures help in avoiding hospital acquired infection’. An example of such disease is common
eye infection. The infection of eyes mainly happen because of bacteria present in the hands. So
before touching the eyes, it is very important to wash the hands properly. The search strategy
was planned using the key words. For conducting the research and effectively prepare the plan
Boolean operators and other database researching tools were used. The key words are the search
elements which target the web traffic towards the research (McCusker & Gunaydin, 2015). The
key terms are the specific terms relate to the topic. The key words that are used for the topic,
‘effect of maintaining ad hygiene on reducing the hospital acquired infections” are hand hygiene,
hospital acquire infection, patients, reduction of diseases. The Boolean operator have been used
in this research for connecting and defining the relationships of the key words in the databases.
The Boolean operators that have been used in this research are AND, OR and NOT (Grover &
Basu, 2017). The examples of the connection of the search terms and the Boolean operator are-
hand hygiene and the reduction of the hospital acquire infections, OR is used for connecting two
synonyms like effective or non-effective. NOT is used for exclusion of an undesired tern from
the research. The databases the collection of various information and data on a particular topic. A
database is assessed by using various searching tools of databases like PubMed and SAGE.
CINAHL: It covers literature/journal articles linked to the healthcare and nursing.
PubMed: MEDLINE via PubMed@UIC is to evaluate journal articles, databases and books
relevant to life sciences.
SAGE Research methods: It includes the information of about 120,000 pages of different
journals, and SAGE books. The population and the intervention are described below:

10EVIDEMNCE-BASED NURSING RESEARCH

11EVIDEMNCE-BASED NURSING RESEARCH
PRISMA Flow
chart
Identification
Research identified through
searching the database (N=70)
Id
en
ti Additional identified articles
through other sources (N=15)
Records after removing the duplicates
(n = 40)
Sc
re
en
Articles included
(n = )
Articles screened (n= 35)
(n = )
Eli
gib
ilit Full-text articles included
(n = 15)
Full-text articles under
screening (n= 35)
In
cl Articles included in
qualitative synthesis
(n = 12)
Key terms searched in the nursing database
P (Patient/ Problem/Population) = Reducing
the risk of hospital acquired infections in
patients.
Risk of infection AND patients [PubMed]
Risk of infection AND patients [SAGE
Research methods]
Patients AND prevalence of infection
[PubMed]
Patients AND Prevalence of infection [SAGE
Research methods]
I (intervention) = Hand hygiene
Hand hygiene methods OR hand hygiene
AND patients [PubMed]
[SAGE Hand hygiene methods OR hand
hygiene AND patients ]
Multimodal training AND Reduction in
infection [PubMed]
Multimodal training AND Reduction in
infection
[SAGE Research methods]