Fundamentals of evidence-based Practice-Pearson set project
The evidence-based practice model that has been chosen for this assignment is the ‘John Hopkins nursing evidence-based practice (JHNEBP) model.’ This model is an effective problem-solving approach in the clinical decision-making process, which is widely used globally. Its specific and robust design helps in meeting the needs of nursing practices in three gradual steps. These three steps include practice questions, evidence of the process, and translation. This model aims to ensure quick and appropriate incorporation of the latest research findings into patient care. The practice question of this evidence-based practice will identify the factors associated with fall risks of Mrs. X will try to implement effective strategies to prevent falls. Evidence was collected by reviewing existing literature, database search, documenting patient’s health progress, and utilizing fall-risk assessment tools. The third and final step of this process comprises clinical documentation, collecting feedback from the staff nurses and multidisciplinary team members while maintaining the policies and procedures of the organization (Dang and Dearholt, 2017).
Different sources of evidence have been utilized in this assignment to reinforce evidence-based practice. Among them, the most important force sources include archival records of the recent research studies, direct observation of the patient’s progress, documentation of the reports, and interviews of the staff nurse and multidisciplinary team members. To gather knowledge about the effective medical and nursing interventions to control the complications and fall risks of the patient, recent scholarly articles are the best source of information (Farokhzadian, Khajouei, and Ahmadian, 2015). After implementing the interventions, observing the patients health improvement will present direct evidence of the efficacy of the processes. Documentation of the progress along with interviewing the healthcare professionals may also reflect the effectiveness of the process.
The opportunities to solve the evidence-based practice include having the scope to research the effective practices for the patient’s health improvement, increasing knowledge about the current evidence-based processes, improving the team-leading capacity, teamwork, and cooperation with the team members while cooperating with the team members the organization too. On the other hand, challenges of solving the case include having sufficient scope to research, having a favorable clinical environment, lack of cooperation from the organization and different health professionals.
They were employing various strategies for health, the case in overcoming its challenges. These strategies included appropriate planning of the process, implementing assessment tools (Breimaier, Halfens, and Lohrmann, 2015), educating the staff adequately, requesting the organization’s support, and implementing resources, such as fall prevention booklets and flyers, and anticoagulant therapy booklets.
The Functional Consequence Theory is a guiding framework developed by Miler that assists nurses in providing optimum care to elderly patients, which helps in identifying risk factors to implement appropriate treatment strategies for the health improvement of the patients. This theory highlights the age-related changes of the geriatric patients and changes related to possible risk factors such as physiological changes and psychological changes associated with environmental risk factors (Berg and Cassells, 2015). This theory was useful in solving the evidence-based practice problem while utilizing different nursing assessment tools to identify the health issues and underlying risk factors for Mrs. X.
The nursing assessment, which was done for the patient, included the Adult Admission Assessment (AAA) tool, Ontario modified STRATI FY (OMS) tool, Current geriatric assessment tools, such as observation of the individual patient, collection of her medical history, and a comprehensive physical examination from head to toe. AAA tool was implemented to document all the necessary patient information on her admission. The different assessments completed utilizing this tool include allergies, alertness, water flow, malnutrition screening, skin assessment, immunization status, and fall risks. OMS was utilized in assessing the patient using five different screenings associated with falls, which include mental status, history of falls, vision, mobility, and toileting (cec.health.nsw.gov.au, 2021). Collecting medical history and conducting comprehensive physical examinations are also done to assess the patient’s holistic health needs.
The factors that may be responsible for the negative medical consequences were analyzed. Collecting the assessment data by filling up checklists and interviewing the patient was followed by analyzing the possible risk factors. These risk factors were tried to be addressed by implementing prevention strategies. The age-related factors that may be involved with the existing medical conditions as well as the fall risks were also documented after collecting the clinical assessment data after her admission to the hospital. Analysis of age-related, medical and environmental risk factors is an important step for planning effective treatment and intervention strategies for the patients.
For nursing students, working on various case studies and working on different complications of the clients are great opportunities to increase their knowledge and overall nursing skills.
Working on this evidence-based practice was helpful in gathering knowledge about the management of geriatric health care complications and fall risks. While doing thorough research for collecting documents about different evidence-based practices, I gained knowledge about proper interventions to improve mobility, manage problems related to incontinence and reduce fall risks among geriatric patients. It was a good learning experience, as my existing knowledge and nursing skills were boosted while working actively on this evidence-based practice. The ethical responsibilities of taking consent, providing maximum effort for delivering the best possible healthcare services in collaborating with the other healthcare professionals of the multidisciplinary team helped me develop my professionalism as a nurse.
While collaborating with the client and the multidisciplinary team members, the Health care professional gets to know about the importance of quality improvement of my nursing strategies and planned interventions, which played an important role in enhancing my professional qualities. The workforce effectiveness improves. The person can learn about different approaches to clinical risk management as well as policy development for success in solving the evidence-based practice problems. The concept of consumer safety measures is boosted while working with the team. This is the scope for the futuristic research where evidence-based practices can help the healthcare system to excel.
Berg, R. L., and Cassells, J. S. (2015). Falls in Older Persons: Risk Factors and Prevention. Nih.gov; National Academies Press (US).
Breimaier, H. E., Halfens, R. J., and Lohrmann, C. (2015). Effectiveness of multifaceted and tailored strategies to implement a fall-prevention guideline into acute care nursing practice: a before-and-after, mixed-method study using a participatory action research approach.BMC nursing,14(1), 1-12.
cec.health.nsw.gov.au. (2021). Ontario Modified STRATIFY (Sydney Scoring) Falls Risk Screen. cec.health.nsw.gov.au. Retrieved 11 June 2021, from
Dang, D., and Dearholt, S. L. (2017).Johns Hopkins nursing evidence-based practice: Model and guidelines. Sigma Theta Tau.
Day, J., Taylor, A. C. T., Summons, P., Van Der Riet, P., Hunter, S., Maguire, J., … and Higgins, I. (2017). Home care packages: insights into the experiences of older people leading up to the introduction of consumer directed care in Australia.Australian
Enderlin, C., Rooker, J., Ball, S., Hippensteel, D., Alderman, J., Fisher, S. J., … and Jordan, K. (2015). Summary of factors contributing to falls in older adults and nursing implications.Geriatric Nursing,36(5), 397-406.
Farokhzadian, J., Khajouei, R., and Ahmadian, L. (2015). Evaluating factors associated with implementing evidencebased practice in nursing.Journal of evaluation in clinical practice,21(6), 1107-1113.
Florence, C. S., Bergen, G., Atherly, A., Burns, E., Stevens, J., and Drake, C. (2018). Medical costs of fatal and nonfatal falls in older adults.Journal of the American Geriatrics Society,66(4), 693-698.
Harnisch-Boyd, J., Langley, A., and Newell, A. (2016). Health practitioners perspective on caring for older adults in rural Mainea Pilot Study.
Mitchell, R., Harvey, L., Draper, B., Brodaty, H., and Close, J. (2017). Risk factors associated with residential aged care, respite and transitional aged care admission for older people following an injury-related hospitalisation.Archives of gerontology and geriatrics,72, 59-66.
Peusschers, E., Twine, J., Wheeler, A., Moudgil, V., and Patterson, S. (2015). Documentation of medication changes in inpatient clinical notes: an audit to support quality improvement.Australasian Psychiatry,23(2), 142-146.
Tarbert, R. J., and Singhatat, W. (2020). Skilled nursing resident adherence with wearable technology to offer safer mobility and decreased fall injuries.Journal of Patient Safety and Risk Management, 2516043520979193.
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