Evidence-Based Nursing Research: Patient Sitters Reduce Fall Rates

This essay discusses the application of evidence-based practice (EBP) in nursing, focusing on the use of patient sitters to reduce fall rates among hospital inpatients. It begins by defining EBP and highlighting its importance in ensuring safe and effective patient care through the integration of scientific evidence. The essay then formulates a PICO (Patient, Intervention, Comparison, Outcome) question: "Does appointment of patient sitters reduce fall rates among the hospital inpatients?" The rationale for this question is grounded in the significant harm caused by inpatient falls, especially among the elderly, and the potential for interventions like patient sitters to mitigate this risk. The essay also describes the search strategy used to locate relevant evidence, including the databases consulted (PubMed, CINAHL, Cochrane Library), keywords used (e.g., "patient sitters," "falls," "limb injury"), and the application of Boolean search terms and inclusion/exclusion criteria to refine the search results. The essay concludes by referencing relevant studies and guidelines supporting the use of patient sitters as part of evidence-based fall prevention strategies.

Running head: EVIDENCE BASED NURSING RESEARCH
EVIDENCE BASED NURSING RESEARCH
Name of the Student
Name of the university
Author’s note

1EVIDENCE BASED NURSING RESEARCH
Introduction
Evidence based practice in nursing (EBP)
Evidence based practice can be defined as the use of scientific evidences for determining the best
practice. Evidence based practice in nursing differs from the conventional nursing protocol by
the fact that it enables safe care delivery to the patient on the basis of scientific evidences
(Schmidt & Brown, 2014). EBP involves critical analysis and evaluation of the research findings
and ten determining how the EBP can be applied to the clinical practice.
Purpose of the assignment
EBP enables critical thinking in health care professionals regarding a particular clinical condition
and helps to apply the best interventions. One such way is the development of the PICO
question. The capability to develop a well-built clinical question is one of the fundamental skills
in EBP. Such questions should be directly relevant to the problems of the patient and should be
phrased in way that guides one’s search.
A properly built clinical question has got four components. The PICO tool is useful in
formulating the PICO question.
Brief outline of the steps
P = Patient, Problem, Population
I = Intervention, Prognostic Factor, Exposure
C = Comparison (Can be None or placebo)

2EVIDENCE BASED NURSING RESEARCH
O= Outcome
The completion of the above mentioned steps are done by a literature search using data bases
using relevant search terms.
Problem and answerable question
PICO question- Does appointment of patient sitters reduce fall rates among the hospital
inpatients?
P = Hospital inpatients
I = Appointment of patient sitters or assistants
C = compared to those patients without any sitters.
O=Reduction of the fall rates in the hospital inpatients
Rationale for choosing this PICO question
Slips and falls has been reported as one of the major harm that occurs in the inpatients
and is largely responsible for mortality in the inpatients. Especially the elderly ones. A fall may
cause fractures, internal bleedings, lacerations, leading to increased utilization of the care (Dunne
et al., 2014). In Singapore, one of the leading cause of the injury among the older adults are fall.
As per the reports of the National Registry of Diseases Office (NRDO) of Singapore, in 2012 the
prevalence of the unintended fall has been 277.7 per 100,000 for older adults (Health promotion
Board , 2015). The prevalence rate of the falls has been found to be increasing with age. As per
the research one third of the falls can be prevented. Specific interventions such as appointment of
patient attendants or sitters can reduce the risks of falls (Melnyk et al., 2015). Among the various

3EVIDENCE BASED NURSING RESEARCH
interventions to avoid falls among the hospital inpatients, use of patient sitters for reducing falls
has been identified as an important interventions. Using patient sitters for observing the patients
who are at high risks of falls has been suggested by several literatures as a part of the evidence
based fall prevention guidelines (Lang, 2014). In fact few studies have also suggested the use of
virtual sitters in order for fall reduction in the hospital inpatients.
Locating the evidence
Search strategy
In order to find the evidences a number of databases have been brainstormed such as
PUBMED, CINAHL and Cochrane library. It is required to have a strong focus on the key on the
topic hence specific keywords has to be used such as " patient sitters", " falls" , " limb injury" are
some of the key words that has been used. Boolean search terms such as Falls AND sitters, Fall
AND elderly, Falls AND Singapore were used to search relevant literatures regarding fall rates
in Singapore and the possible interventions followed by the inpatients. Wild cards and
truncations has been used such as * fal OR *elder. This resulted in a huge number of papers
which was further refined by using inclusion criteria. The inclusion and the exclusion criteria has
to be reasonable enough (Aromataris & Riitano, 2014). The inclusion criteria for the researches
were primary researches, systematic reviews. The inclusion criteria included English peer
reviewed journals within 2012 to 2018. Without the limiters, the search at first obtained 145688
results. The application of the inclusion criteria returned a good amount of articles. Websites of
Singapore department of health was also brainstormed through for obtaining the relevant
statistical data related to elderly fall.

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References
Aromataris, E., & Riitano, D. (2014). Systematic reviews: constructing a search strategy and
searching for evidence. AJN The American Journal of Nursing, 114(5), 49-56.
Dunne, T. J., Gaboury, I., & Ashe, M. C. (2014). Falls in hospital increase length of stay
regardless of degree of harm. Journal of evaluation in clinical practice, 20(4), 396-400.
Health promotion Board ( 2015). Falls prevention among older adults living in the community.
Access date: 21.6.2016. Retrieved from:
https://www.hpb.gov.sg/docs/default-source/pdf/cpg_falls_preventionb274.pdf?
sfvrsn=abedeb72_0
Lang, C. E. (2014). Do sitters prevent falls?: A review of the literature. Journal of
gerontological nursing, 40(5), 24-33.
Melnyk, B. M., Gallagher‐Ford, L., Long, L. E., & Fineout‐Overholt, E. (2014). The
establishment of evidence‐based practice competencies for practicing registered nurses
and advanced practice nurses in real‐world clinical settings: proficiencies to improve
healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence
‐
Based Nursing, 11(1), 5-15.
Schmidt, N. A., & Brown, J. M. (2014). Evidence-based practice for nurses. Jones & Bartlett
Publishers.