An Introduction to Clinical Inquiry and Research Methodologies.
An Introduction to Clinical Inquiry and Research Methodologies.
Evidence-Based Practice (EBP): Identification of Research Methodologies from Peer-Reviewed Studies on Fall Rates in Elderly Patients
The concept of evidence-based practice or EBP is the current driving force behind effective nursing clinical practice. It is a concept that is premised on a simple and straightforward assertion. It is that each and every nursing intervention that is used on a patient must have scholarly evidence that supports its efficacy in bringing about desired patient outcomes. An Introduction to Clinical Inquiry and Research
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The terms ‘best practice’ refer to a clinical practice situation in which EBP reigns. The opposite is a situation in which nurses utilize different interventions just because they have always seen other nurses using them. They do not question whether they are efficacious or not. This is what is referred to a common practice (Melnyk & Fineout-Overholt, 2019). An Introduction to Clinical Inquiry and Research Methodologies.To get evidence for a practice, clinical inquiry is used and research databases are searched for peer-reviewed scholarly literature. The clinical practice problem in this project is patient falls among the elderly (aged 65 years and above). Scholarly literature that is peer-reviewed and providing evidence for the efficacy of interventions in preventing patient falls in the elderly was retrieved. This paper is about identifying the research methodologies used in four of these articles that were retrieved.An Introduction to Clinical Inquiry and Research Methodologies.
Matrix Worksheet of Four Peer-Reviewed Articles on Patient Fall Prevention Interventions and their Methodologies
Table: Matrix worksheet identifying research methodologies from studies on fall interventions for elderly patients
| Full citation of selected article | Article #1 | Article #2 | Article #3 | Article #4 |
| Gavaller, M., Gavaller, M., & Oh, H. (2019). Impact of bed alarm removal and implementation of hourly rounding to reduce falls. Journal of the American Medical Directors Association, 20(3), B19. https://doi.org/10.1016/j.jamda.2019.01.080
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Goldsack, J., Bergey, M., Mascioli, S., & Cunningham, J. (2015). Hourly rounding and patient falls. Nursing, 45(2), 25-30. https://doi.org/10.1097/01.nurse.0000459798.79840.95
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Kojima, G., Kendrick, D., Skelton, D., Morris, R., Gawler, S., & Iliffe, S. (2015). Frailty predicts short-term incidence of future falls among British community-dwelling older people: a prospective cohort study nested within a randomized controlled trial. BMC Geriatrics, 15(1). https://doi.org/10.1186/s12877-015-0152-7 | Morgan, L., Flynn, L., Robertson, E., New, S., Forde-Johnston, C., & McCulloch, P. (2016). Intentional rounding: A staff-led quality improvement intervention in the prevention of patient falls. Journal of Clinical Nursing, 26(1-2), 115-124. https://doi.org/10.1111/jocn.13401
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| Why you chose this article and/or how it relates to the clinical issue of interest (include a brief explanation of the ethics of research related to your clinical issue of interest) | I chose this article because it addresses the quality improvement problem of accidental patient falls. It relates to my clinical issue of interest in that it investigates the efficacy of hourly rounding as opposed to bedside alarms alone. The ethics of research related to the clinical issue of interest is in upholding nonmaleficence by preventing falls that injure the elderly patients.An Introduction to Clinical Inquiry and Research Methodologies. | I chose this article because it also investigates an intervention aimed at preventing patient falls in an efficacious way. It relates to my clinical issue of interest in that it considers the efficacy of hourly rounding in preventing patient falls. Like the first study, the ethics of research here lie in preventing harm to the patient (nonmaleficence). | I chose this study because it is about the relationship between frailty and the likelihood of falls occurring. It is related to my clinical issue of interest in that frailty is the defining characteristic of elderly patients who are the subject of my clinical issue of interest. Ethically, any intervention is supposed to bring only good (beneficence) and prevent harm to te patient (nonmaleficence). | I also chose this study because like two of the other studies in this matrix, it investigated the efficacy and impact of intentional hourly rounding by nurses on a shift on preventing patient falls. It relates to my clinical issue because elderly patients are the ones most at risk of accidental falls.
The ethics of research require that harm not be caused to patients (nonmaleficence). |
| Brief description of the aims of the research of each peer-reviewed article | To evaluate the effect on fall rates of the removal of bed alarms and implementation of hourly rounds by nurses. | To investigate the effect of interdisciplinary teamwork and hourly nursing rounds on the accidental fall rate in an inpatient setting. | To examine the correlation between frailty and the incidence of future falls among a group of older patients. | To evaluate the effect of a nurse-led intentional rounding intervention on the rate of accidental patient falls. |
| Brief description of the research methodology used Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific. | This was a quantitative study comparing fall rates in the six months before and after removal of the bedside alarms (and start of hourly nursing rounds).An Introduction to Clinical Inquiry and Research Methodologies. | This was a 30-day quantitative prospective pilot study. It included pre- and post-implementation evaluation. | This was a quantitative prospective cohort study. It was designed to take place within a randomized controlled trial. | This was a quantitative study of a customized intentional rounding intervention as a quality improvement initiative to prevent falls. |
| A brief description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected. | The strength of this study was in its experimental design. This ensured the internal validity was sound and that reliability could be assured from the results.
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The study was experimental in design with a sizeable sample size (n = 75). The design and sampling improved validity, even though this was a convenience sample. With validity assured, generalizability of the study is also not questionable. | The strength of this study is in its experimental design as well as its good sample size of n = 248. The sample size and design assure validity. It is hard for validity to be present without reliability. Therefore the study also has generalizability of its results. | The multipronged design of this study represents its strength. Because of this, various confounding variables could be controlled. this strengthened the study’s internal validity and reliability. |
| General Notes/Comments | The importance of this study to clinical practice cannot be overemphasized. These findings are invaluable in the prevention of falls in elderly patients. | The finding of effectiveness of hourly nursing rounds in preventing falls is significant for clinical practice. | This study is relevant to my clinical issue of interest and will build on EBP. | The findings of the study are important in improving evidence-based practice. |
