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Benchmark -Evidence-Based Practice Project: Literature Review

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Benchmark -Evidence-Based Practice Project: Literature Review

1. Introduction 

Among the elderly, especially those people aged 65 years and above, falls have been a

major issue over the years. They have a high fall prevalence, with some fall cases resulting in

injuries and other complications. Hypothetically, some aspects, such as functional impairment,

pain, mortality, and disability, have been linked to this population’s high rates of falls. As such,

the risk factors for falling among the elderly should be identified, and appropriate interventions

should be implemented. The proposed study addresses this problem of falls among the elderly 65

years and above. The research seeks to study how bedside alarms can prevent or control these

falls in long-term care facilities. The hypothesis is that introduction of bedside alarms in long-

term care facilities will reduce elderly-patient-falls significantly for the six months of

intervention.

2. Search methods

Identifying the most appropriate sources was a major factor of consideration when

starting with the proposal. This practice ensures that I get the right, correct, and up-to-date

information on my topic. There are a few ways to search for research articles. For this research, I

employed the most common search practices. In my first search strategy, I used a search engine

where Google was the primary search engine. Secondly, I used a library database such as

PubMed, where I could identify relevant and appropriate sources. Finally, I used a common

search strategy where one can search for research articles by using the search function on a

journal website. I needed to identify relevant sources through different strategies to find research

articles through these styles. I could identify these relevant sources by doing a general search for

keywords and then scrutinizing the resources on aspects such as the dating of the publication. 
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In this search practice, I could start by going to a library website or available search

engine. After getting into these sections, I could type in my keywords which included Patient

fall, long-term care unit, bedside alarm, and reducing patient falls in LTCF, among others. After

the available sources were accessed through this search, I could look for articles published within

the last five years. I could go through those articles to identify the information relevant to my

topic. The articles qualifying for selection and inclusion into the study were those that responded

to the issue in my PICOT statement. The process was repeated until I had enough articles for the

task. Besides, search criteria were strategically focused on sources based on LTCF and attended

to patients with fall prevalence or meant to reduce patients’ falls. Besides, by use of the google

scholar platform, I could select relevant sources based on the fore mentioned inclusion criteria,

including the dating and journal sources. This search selected other relevant resources, including

journal articles and systemic reviews. All the identified resources had to be peer-reviewed

sources for validity and reliability purposes.

3. Synthesis of the literature

Bouda, P. (2022). Preventing Falls Using Evidence-based Interventions in a Long-term

Care Facility. https://irl.umsl.edu/cgi/viewcontent.cgi?

article=2243&context=dissertation

This study by Bauda was quantitative research that implemented descriptive,

observational, and comparative intervention using purposeful and convenience sampling

methods. The study was based in an LTC facility in Missouri where memory care patients were

used as the test subjects. The study’s main purpose was to test the effectiveness of evidence-

based interventions (4Ps) in reducing falls in a memory care unit of an LTC facility. The study

found that implementing this evidence-based intervention significantly reduced patient falls in
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the LTC facility. The rationale for this source is its insight into evidence-based interventions. It

will shed more light on the study and guide implementation.

Hempel, S., Newberry, S., Wang, Z., Booth, M., Shanman, R., Johnsen, B., ... & Ganz, D. A.

(2017). Hospital fall prevention: a systematic review of implementation,

components, adherence, and effectiveness. Journal of the American Geriatrics

Society, 61(4), 483-494. https://doi.org/10.1111/jgs.12169

This research study follows a systematic review design to document the implementation,

components, comparators, adherence, and effectiveness of the existing and documented fall

prevention strategies. The study was based on US acute hospitals. The subjects were those

studies that evaluated fall reduction interventions in hospitalized residents. Fifty-eight

publications met the inclusion criteria and were used in the study. The study found that the

regression analysis did not show an association between implementation intensity, intervention

complexity, comparator information, adherence levels, and IRR.

Cameron, E. J., Bowles, S. K., Marshall, E. G., & Andrew, M. K. (2018). Falls and long-

term care: a report from the care by design observational cohort study. BMC

Family Practice, 19(73). https://doi.org/10.1186/s12875-018-0741-6 

The study followed a cross-sectional design utilizing data from the Care by Design

(CBD) study. The data was collected from Nova Scotia’s Capital District Health Authority. The

data were collected before, during, and after the implementation of the CBD. The collected data

was analyzed after the model was implemented in the LTCF. Three hundred ninety-five residents

from the LTF were included in the study. The main findings in the study were that falls were

common in long-term care facilities and were associated with several factors, including age,

frailty, and cognitive impairment.

Additionally, the study found that falls were a significant risk factor for long-term care

facility admission and that interventions aimed at preventing falls in residents were likely to be

effective. The study will help identify the risk factor to attend to when conducting the research. It

equally identifies the population at high risk of falling.

Shorr, R. I., Chandler, A. M., Mion, L. C., Waters, T. M., Liu, M., Daniels, M. J., ... &

Miller, S. T. (2019). Effects of an intervention to increase bed alarm use to prevent

falls in hospitalized patients: a cluster randomized trial. Annals of internal

medicine, 157(10), 692-

699. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3549269/

The study was built around the hypothesis that bed alarms help reduce hospital falls, but

the issue has yet to be evaluated fully. The study intended to investigate whether increasing bed

alarms use could lead to plausible results. It was a pair-matched, cluster-randomized trial

research. The study included 16 nursing units in an urban community hospital. The test subjects

were 27 672 inpatients in general medical, surgical, and specialty units. The study found that the

intervention implied was focused on increasing bed alarm systems, but little was put on th

patient-fall events. The rationale for choosing this resource is that it will help guide the research

by alleviating the mistake of neglecting fall events.

Okumoto, A., Miyata, C., Yoneyama, S., & Kinoshita, A. (2020). Nurses’ perception of the

bed alarm system in acute-care hospitals. SAGE Open Nursing, 6,

2377960820916252. https://doi.org/10.1177/2377960820916252

The study investigated nurses’ perceptions of the appropriateness of considering bedside

alarms as physical restraints. A quantitative study was conducted using bivariate logistic

regression. The subjects were 289 nurses from 10 acute-care facilities. The results showed that
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74% (214) of the nurses considered alarms a form of restraint. These results imply that many

nurses approve of alarming bedside intervention. The rationale for choosing this source is that it

creates a rough image or ideology of how the research study will be accepted.

Mileski, M., Brooks, M., Topinka, J. B., Hamilton, G., Land, C., Mitchell, T., ... & McClay,

R. (2019, March). Alarming and/or alerting device effectiveness in reducing falls in

long-term care (LTC) facilities? A systematic review. In Healthcare (Vol. 7, No. 1, p.

51). MDPI.

The research study is a systematic review where researchers reviewed alarming and/or

alarm systems and their potential effectiveness in the reduction of patient fall in LTC facilities.

After the critical sampling method involving inclusion and exclusion criteria, 28 articles were

selected as test subjects for analysis. The study found a lack of evidence to support the use of

alarming and/or alerting devices to reduce falls in long-term care (LTC) facilities. However,

there is some evidence that alarming and/or alerting devices may effectively prompt residents to

take corrective actions. However, the effectiveness of these devices in reducing falls still needs

to be proven. There is a need for more research to understand better the effectiveness of alarming

and/or alerting devices in reducing falls in LTC facilities. 

Jähne-Raden, N., Kulau, U., Marschollek, M., & Wolf, K. H. (2019). EMBED: a highly

specialized system for bed-exit-detection and fall prevention on a geriatric ward.

Sensors, 19(5), 1017. https://doi.org/10.3390/s19051017

The study’s main objective was to evaluate the accuracy and reliability of the INBED

system for bed exit detection and fall prevention in a geriatric ward. The study found that the

INBED system can detect the user’s exit from the bed with high accuracy and reliability. The

system can be integrated into an existing clinical environment rather easily. These findings imply
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that the INBED system could be a valuable tool for bed-exit detection and fall prevention in a

geriatric ward. It could help improve the safety of patients living in a geriatric ward. The

rationale for this research article selection is that it provides an overview of the effectiveness and

implementation of bedside alarms.

Tanwar, R., Nandal, N., Zamani, M., & Manaf, A. A. (2022, January). Pathway of trends

and technologies in fall detection: a systematic review. In Healthcare (Vol. 10, No. 1,

p. 172). MDPI. https://doi.org/10.3390/healthcare10010172

This study followed a systematic literature review of peer-reviewed articles. The key

findings in this study are as follows: 

1) There is a growing trend of using sensor-based fall detection technology. 

2) This technology has several benefits, including detecting falls early and accurately.

The rationale for selecting this study is that it will offer insight into what is expected of the

technological intervention implemented in hospitals. It will be a resourceful guide for the

proposed study.

4. Comparison of articles

These research articles are important sources of information for the proposed study. They

will guide the study by generating and availing different evidential information on the aspect of

falls and the reduction of falls in different settings. They are similar in that they are concerned

with people’s health and the falling problem in society. For most of the studies, the focus is

generated on older adults and their care, identifying that they have the highest risk of falling.

Equally, a good number of studies are based on LCT facilities. These are of significant

importance for this study since it will be based in such a facility and concerned with the care of

older adults.
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However, there are imminent differences between these studies. First, some are

systematic reviews, implying that they were not evidence-based but rather depend on

information from secondary sources. For those studies that were ground practices, evidence and

results will be regarded primarily, and analysis of this information will be helpful. Another

difference lies in the overall purpose of the studies. Some studies are conducted to assess bedside

alarms’ effectiveness, while others aim to gather people’s perspectives concerning this

intervention. It is for this reason that some studies fail to produce conclusive results.

5. Suggestions for future research

Regarding the identified study materials, some considerations will be imminent. First, it

is important to ensure that the right implementation methodologies are used in the study. Here,

shortcomings will be alleviated where the right channels drive the study to achieve the intended

goal. In one of the studies, interventions on utilizing bedside alarms were conducted. However,

the implementing strategy diverted the study from fall events focusing on increasing bedside

alarm use. Secondly, it will be vital if the concerns of the elderly and other people at risk of

falling are considered. These events can lead to complications and injuries. Therefore, their lives

will be improved if they are provided with the right evidence-based interventions. Lastly, it is

important to ensure that healthcare facilities are enlightened and supplied with the right and

current technological intervention, especially in acute care facilities. The risk of adversities in

health in these facilities is increasing. Therefore, the need for improved strategies of care is

imminent.

6. Conclusion 

The literature assessed offers a wide range of information on fall reduction. While some

research materials focus on determining the appropriateness and effectiveness of evidence-based

interventions, others investigate the perspectives evoked by these interventions in different

people and settings. These pieces of information can be assembled and summarized into helpful

pieces of insight. After analyzing these materials, it is clear that bedside alarms and alarm

systems are practical interventions that the LTC facilities can get. While traditional methods

entailed nurses and practitioners rounding in the facilities, these alarms will send notifications

calling for the nurses to act accordingly. Therefore, there will be a great reduction in errors and

late responses. It is for this reason that the proposed research remains positive that the

implementation of the proposed strategy will provide positive and adequate evidence.

Considering the elderly and other patients in the LTC facilities is critical. It is prudent if the risk

factors and causes of falls are identified and rectified accordingly.

 
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References

Bouda, P. (2022). Preventing Falls Using Evidence-based Interventions in a Long-term Care

Facility. https://irl.umsl.edu/cgi/viewcontent.cgi?article=2243&context=dissertation

Cameron, E. J., Bowles, S. K., Marshall, E. G., & Andrew, M. K. (2018). Falls and long-term

care: a report from the care by design observational cohort study. BMC Family Practice,

19(73). https://doi.org/10.1186/s12875-018-0741-6

Hempel, S., Newberry, S., Wang, Z., Booth, M., Shanman, R., Johnsen, B., ... & Ganz, D. A.

(2017). Hospital fall prevention: a systematic review of implementation, components,

adherence, and effectiveness. Journal of the American Geriatrics Society, 61(4), 483-494.

https://doi.org/10.1111/jgs.12169

Jähne-Raden, N., Kulau, U., Marschollek, M., & Wolf, K. H. (2019). INBED: a highly

specialized system for bed-exit-detection and fall prevention on a geriatric ward. Sensors,

19(5), 1017. https://doi.org/10.3390/s19051017

Mileski, M., Brooks, M., Topinka, J. B., Hamilton, G., Land, C., Mitchell, T., ... & McClay, R.

(2019, March). Alarming and/or alerting device effectiveness in reducing falls in long-

term care (LTC) facilities? A systematic review. In Healthcare (Vol. 7, No. 1, p. 51).

MDPI.

Okumoto, A., Miyata, C., Yoneyama, S., & Kinoshita, A. (2020). Nurses’ perception of the bed

alarm system in acute-care hospitals. SAGE Open Nursing, 6, 2377960820916252.

https://doi.org/10.1177/2377960820916252

Shorr, R. I., Chandler, A. M., Mion, L. C., Waters, T. M., Liu, M., Daniels, M. J., ... & Miller, S.

T. (2019). Effects of an intervention to increase bed alarm use to prevent falls in

hospitalized patients: a cluster randomized trial. Annals of internal medicine, 157(10),

692-699. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3549269/

Tanwar, R., Nandal, N., Zamani, M., & Manaf, A. A. (2022, January). Pathway of trends and

technologies in fall detection: a systematic review. In Healthcare (Vol. 10, No. 1, p. 172).

MDPI. https://doi.org/10.3390/healthcare10010172