This assignment will help you in developing your Bare Bones Research Proposal further. You will use the evidence that you began identifying in your Problem Identification and PICOT Assignment and build on it in this assignment. In this paper, you are providing evidence/statistics that support that your topic is a problem in clinical practice, establishing the significance of the problem to nursing, and reviewing and synthesizing current literature about your topic. Use the following headings to develop APA headings for your paper. Include the following information in each section.

Introduction: Begin with a broad introduction to the topic that grabs the reader’s attention. Typically present broad statistical background on the issue. Nearly every sentence should be referenced.

Problem Statement: Begin defining the problem here—include more detailed statistics—specifically about the population you plan to examine. What is the importance to the public? Nearly every sentence should be referenced.

Significance of the study to nursing: (as obtained from the literature). This must be referenced, not your opinion. The significance section should provide information as to why it is important to fill in any gaps in knowledge or why it is important to improve patient outcomes. Describe and summarize who will be able to use the knowledge your study provides and, if applicable, how the results of your study might help make practice decisions, improve policy, or change practice as a whole.

Literature review and synthesis: Review relevant literature and write a literature synthesis on your identified problem with at least seven recent, scholarly, research-based, and diverse articles (at least three of which come from nursing journals). These articles should be scholarly or research based in nature. Do not use web pages, newspapers, or non-refereed journals. Do not use any .com references. You will describe the variables of your study here. This section should be heavily referenced. Try to synthesize your findings. Do not just summarize each of the articles individually. You will identify your variables in this section. For example:

Does the utilization of music therapy in addition to oral pain medications impact pain levels as compared to oral pain medications alone in orthopedic post surgical patients on post-operative day one?

Your dependent variable is post-operative pain levels and your independent variable is music therapy. You would synthesize current literature on music therapy and post operative pain (or even pain and the management of pain in general).

Purpose: Identify the purpose of the study. You will write this as: The purpose of the study is to….

Typical phrasing examples include:
The purpose of the study is to examine the effectiveness of X intervention on Y. X would be the independent variable and Y would be the outcome or dependent variable.
The purpose of the study is to identify whether a correlation exists between X and Y.
The purpose of the study is to determine whether X has an influence on Y.
The purpose of the study is to explore factors that (influence, describe, correlate, etc.) Y variable.

The purpose statement also includes the target population.

Hypothesis or Research Question/PICOT Question: Select which one is most appropriate for your design and congruent with your purpose. You will choose either a hypothesis or a research question, not both. These will be a restatement of your purpose as either a hypothesis or a question.

After receiving feedback on this assignment, you will be able to incorporate the sections of this paper into your final Bare Bones Proposal assignment. See the attached grading rubric below.

Problem Identification and PICOT Assignment

 Student’s Name

Institutional Affiliation

Course

Instructor’s Name

Date

Problem Identification and PICOT Assignment

Part 1: Introduction

Hospitalized patients are often a high risk for falls, which may lead to serious injuries such as subdural hematomas, hip fractures, and even death sometimes. Among hospitalized patients, falls present a leading cause of preventable injuries, like those named above (Dykes et al., 2020). Injurious falls have a financial burden on patients and families. They are also associated with additional 6 days to a patient’s hospitalization. According to Carter et al. (2020). Fall TIPS (Tailoring Interventions for Patient Safety) tool was the first patient-centered and clinical decision-supported fall prevention program tested in a randomized controlled trial. Evidence-based literature has supported the implementation of the Fall TIPS program focused on inpatient fall prevention to reduce incidents of falls (Khandagale, 2021). The tool kit provides care team members with the information they need to routinely engage in the fall-prevention process. This paper presents PICO questions, search terms, and evidence table related to patient falls in hospitalized patients.

Part 2 (PICO)

In hospitalized patients with a higher risk of falling (P), how does Fall TIPS (Tailoring Interventions for Patient Safety) (I) compared to no intervention (C) affect fall rates among the patients (O)?

Part 3 (Search Terms)

A search of the literature was conducted using Google Scholar, PubMed, ResearchGate, and ProQuest. Keywords used include falls, hospitalized patients, preventable injuries, Tailoring Interventions for Patient Safety (TIPS), Accidental Falls–prevention & control, quality improvement, and inpatients. Retrieved articles were obtained from peer-reviewed journals published between 2018 and 2022.

 

 

Part 4 (Evidence Table)

NSG 6691 Research and Evidence for Advanced Practice Nursing

Evidence Table of Literature Review Template Example

 

PICOT: (Be sure to use the appropriate format for phrasing the question)

Reference in APA format	Setting / Sample Size	Purpose of the study/Outcome Measures	Research Design / Level of Evidence/ Intervention / Theoretical Framework (if used)	Limitations/ Threats to validity/ Results
Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., … & Bates, D. W. (2020). Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial. JAMA network open, 3(11), e2025889-e2025889. https://doi.org/10 .1001/jama.2010.1567	Setting: 14 medical units within 3 academic medical centers in Boston and New York City.   Sample: 17 948 patients were included in the pre-intervention period and 19 283 in the post-intervention period. Patients in both periods were similar regarding age, sex, race/ethnicity.	Purpose:  To assess whether a fall-prevention tool kit that engages patients and families in the fall prevention process throughout hospitalization is associated with reduced falls and injurious falls. Outcome measures: Reduced falls and injurious falls	Design: nonrandomized controlled trial using stepped wedge design. Level of Evidence: III   Intervention: A nurse-led Fall TIPS.	Limitations:  Despite evidence that participatory design and development with end users strengthen interventions, they also make quantifying the association between the intervention and a reduction in falls more difficult. Results: the implementation of a fall prevention tool kit was associated with a significant reduction in falls and related injuries.

 

Reference	Setting / Sample Size	Purpose of the study/Outcome Measures	Research Design / Level of Evidence/ Intervention / Theoretical Framework (if used)	Limitations/ Threats to validity/ Results
Carter, E. J., Khasnabish, S., Adelman, J. S., Bogaisky, M., Lindros, M. E., Alfieri, L., & Dykes, P. C. (2020). Adoption of a patient-tailored fall prevention program in academic health systems: a qualitative study of barriers and facilitators. OBM Geriatrics, 4(2), 15. 10.21926/obm. geriatr.2002119	Setting: 11 hospitals representing three academic health systems.   Sample: Staff N-71 Patients N=50 and Family Members N=7	Purpose:  to identify dominant facilitators and barriers to Fall TIPS adoption.   Outcome measures: facilitators and barriers to Fall TIPS adoption.	Design: A Multisite qualitative study design   Level of Evidence: III   Intervention: Staff focus and patients interview conducted in 2 phases.	Limitations:  selected health systems had high rates of Fall TIPS compliance. The voluntary self-selection of participants is a possible source of bias. Results: Facilitators: Staff motivation to Address Falls. Patients and their Families Welcomed their Role in Fall Prevention. 3 Fall TIPS was Integrated into Existing Staff Workflows. Barriers: Poor Patient Engagement Practices among Staff. Residual Language and Fall Prevention Approaches. Patient-Level Considerations.

 

Reference	Setting / Sample Size	Purpose of the study/Outcome Measures	Research Design / Level of Evidence/ Intervention / Theoretical Framework (if used)	Limitations/ Threats to validity/ Results
Khandagale, U. (2021). Implementation of a Fall Prevention Toolkit on a Medical Surgical Unit (Doctoral dissertation, University of Maryland at Baltimore). https://archive.hshsl. umaryland .edu/handle/10713/15802	Setting: A community-based hospital in a 32- bed acute care medical surgical unit. Sample: A total of 43 nurses received education.	Purpose:  to implement and evaluate the benefits of, and staff adherence to, the use of Fall TIPS toolkit to reduce falls on a medical surgical unit. Outcome measures: Nurses adherence to the tool kit. Patient fall rates.	Design: Post and pre intervention qualitative study design. Level of Evidence: III   Intervention: Fall TIPS (Tailoring Intervention for Patient Safety) toolkit).	Limitations: the results are limited to a single patient unit. Nurses expressed fatigue due to constant new changes, which may have limited their adherence to the fall prevention measures. Results: nurses’ adherence to use of the Fall TIPS toolkit averaged 78%. Fall rates dropped to zero during the third month.

 

 

 

 

Part 5 (Conclusion)

All three sources of evidence have agreed that falls may cause serious injuries to patients. Some of the injuries that may arise from patient falls include subdural hematomas, hip fractures, and even death. Additionally, the sources of evidence have shown that the Fall TIPS (Tailoring Interventions for Patient Safety) tool is effective in reducing the rate of patient falls among inpatients. A PICO question and search terms have also been discussed in this paper.

References

Carter, E. J., Khasnabish, S., Adelman, J. S., Bogaisky, M., Lindros, M. E., Alfieri, L., & Dykes, P. C. (2020). Adoption of a patient-tailored fall prevention program in academic health systems: a qualitative study of barriers and facilitators. OBM Geriatrics, 4(2), 15. 10.21926/obm.geriatr.2002119

Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., … & Bates, D. W. (2020). Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial. JAMA network open, 3(11), e2025889-e2025889. https://doi.org/10.1001/jama.2010.1567

Khandagale, U. (2021). Implementation of a Fall Prevention Toolkit on a Medical Surgical Unit (Doctoral dissertation, University of Maryland at Baltimore). https://archive.hshsl.umaryland.edu/handle/10713/15802