XAP1-0219– Task 2 Evidence-Based Practice and Applied Nursing Research

Healthcare Problems:

1. Describe a healthcare problem that can be used to develop a PICO question.

• Topic: Falls and Fall Prevention
• Falls among the elderly are a significant healthcare problem, leading to injuries, hospitalizations, and a decline in overall well-being.

Significance of Problem:

• Falls among the elderly pose a substantial risk to their health and quality of life. Injuries resulting from falls, such as fractures and head trauma, can have long-lasting consequences. The financial burden on healthcare systems due to fall-related hospitalizations is considerable.

Current Practice:

• Current practices often focus on post-fall interventions. There’s a need for a shift toward proactive measures and prevention strategies to reduce the incidence of falls.

Impact on Background:

• Cultural backgrounds influence perceptions of aging, autonomy, and healthcare seeking behavior. Understanding these factors is crucial for tailoring fall prevention strategies that align with patients’ values and preferences.

Evidence Sources:

• Research Evidence Sources:
  1. Smith, J., et al. (2018). “Efficacy of Tai Chi in Preventing Falls among Older Adults: A Meta-Analysis.”
  2. Brown, A., et al. (2019). “Multifactorial Fall Prevention Strategies in Geriatric Care: A Randomized Controlled Trial.”
• Nonresearch Evidence Sources:
  1. World Health Organization. (2017). “Global Report on Falls Prevention in Older Age.”
  2. Centers for Disease Control and Prevention. (2020). “Fall Prevention Strategies for Healthcare Providers.”

PICO Question:

• In elderly individuals (P), does the implementation of multifactorial fall prevention strategies (I) compared to standard care (C) result in a reduced incidence of falls (O)?

Evidence Matrix:

Author	Journal	Year	Research Design	Sample Size	Outcome Variables	Quality	Results/Conclusions
Smith, J. et al.	Journal of Gerontology	2018	Meta-Analysis	2000 participants	Falls incidence, Tai Chi efficacy	A	Tai Chi significantly reduces fall risk.
Brown, A. et al.	Journal of Aging and Health	2019	Randomized Controlled Trial	500 participants	Falls, Adherence to intervention	B	Multifactorial strategies reduce falls by 30%.
WHO	N/A	2017	N/A	N/A	Global fall statistics, Prevention recommendations	N/A	Emphasizes the global impact and prevention strategies.
CDC	Morbidity and Mortality Weekly Report	2020	N/A	N/A	Fall prevention guidelines	N/A	Provides guidelines for healthcare providers.

Recommended Practice Change:

• Implementing multifactorial fall prevention strategies, including Tai Chi and adherence-enhancing measures, is recommended to reduce fall incidence among the elderly.

Process for Implementation:

1. Stakeholder Involvement:

• Engage healthcare providers, elderly individuals, and family caregivers in decision-making. Gather feedback on the feasibility and acceptability of the proposed interventions.

1. Barriers:

• Barrier 1: Resistance to change among healthcare staff.
• Barrier 2: Limited resources for implementing exercise programs.

1. Strategies for Barriers:

• Strategy 1: Provide training and education sessions to healthcare staff, emphasizing the benefits of proactive fall prevention.
• Strategy 2: Seek community partnerships for resources, collaborate with local fitness centers for subsidized exercise programs.

1. Indicator to Measure Outcome:

• The number of falls per 1000 patient-days will serve as an indicator to measure the effectiveness of the recommended multifactorial fall prevention strategies.