Best Practice from the Review

The study evaluated research evidence from four peer-reviewed articles to appraise the effectiveness of alarm sensors in reducing falls among elderly hospitalized patients. Although the four articles used different methodologies to collect and analyze data for their levels of evidence, they all reveal a positive effect of sensors as interventions in preventing falls for elderly hospitalized patients. Many patients experience negative hospital outcomes when they fall while receiving care in the hospital. Barker et al. (2016) conducted a study to establish the effect of the 6-PACK program on falls and fall injuries in acute care settings in 24 acute wards. The intervention included the use of technological alerts to notify care providers about movement or the need for the movement to prevent falls among acute care patients. The study revealed positive changes in the prevention of falls following the use of the 6-PACK program.

The study revealed that effective evidence-based interventions are necessary to prevent falls amongst hospitalized patients. In a systematic review of literature, Hamm, Money, Atwal, and Paraskevopoulos (2016) revealed the positive impact of technology-based applications in fall prevention in hospitals. Although the study used a different methodology from Barker et al. (2016) who conducted an intervention study, the two studies found a positive effect of technology in fall prevention outcomes. The evidence shows the need to train nurses to comply with technology-based interventions to prevent falls. The studies revealed the positive effect of technology used to detect falls and prevent related injuries. Effective actions include monitoring movement, using fall detectors, and medical interventions to prevent negative outcomes of falls. The study differs from Barker et al. (2016) because it does not use interventions to prevent falls, but rather to detect falls and prevent related injuries.

From the review of the articles, the best practice to prevent falls among hospitalized patients is to use technological sensors that prevent falls, detect the incidents, and avoid negative outcomes in case falls occur. Just as the study conducted by Hamm, Money, Atwal, and Paraskevopoulos (2016), Khosravi and Ghapanchi (2016) conducted a systematic review of the literature to establish the impact of Information and Communication Technologies to support the elderly in their daily activities and prevent negative outcomes such as falls and related injuries. The authors confirmed that assistive technologies play an important role in improving the quality of life for the elderly in healthcare settings. However, the study differs from the rest because it includes the aspect of acceptance of the technology by seniors for improved outcomes,

Shee, Phillips, Hill, and Dodd (2014) conducted an experimental study to test the effect of electronic sensor alarm in preventing falls among hospitalized patients. Methodologically, the study is similar to Barker et al. (2016) because they are both primary intervention and experimental studies to establish the effect of technology in preventing falls. However, the other two have a level III Evidence because they are systematic reviews of previous evidence on fall prevention among hospitalized elderly patients. The studies further suggested the need for health care practitioners to comply with fall prevention practice to protect patients in various hospital settings from the burden of care and additional costs of treating fall-related injuries. Thus, nurses should develop the knowledge of proper use of fall prevention technology such as sensors. The four studies revealed similar findings on the use of technology to prevent falls and fall-related injuries.

 

 

 

 

Critical Appraisal Tools Worksheet Template

Evaluation Table

 

Use this document to complete the evaluation table requirement of the Module 4 Assessment, Evidence-Based Project, Part 4A: Critical Appraisal of Research

 

 

Full citation of selected article	Article #1	Article #2	Article #3	Article #4
	Barker, A. L., Morello, R. T., Wolfe, R., Brand, C. A., Haines, T. P., Hill, K. D., … & Sherrington, C. (2016). 6-PACK programme to decrease fall injuries in acute hospitals: Cluster randomised controlled trial. BMJ, 352, 1-8.	Hamm, J., Money, A. G., Atwal, A., & Paraskevopoulos, I. (2016). Fall prevention intervention technologies: A conceptual framework and survey of the state of the art. Journal of Biomedical Informatics, 59, 319-345.	Khosravi, P., & Ghapanchi, A. H. (2016). Investigating the effectiveness of technologies applied to assist seniors: A systematic literature review. International Journal of Medical Informatics, 85(1), 17-26.	Shee, A. W., Phillips, B., Hill, K., & Dodd, K. (2014). Feasibility, acceptability, and effectiveness of an electronic sensor bed/chair alarm in reducing falls in patients with cognitive impairment in a subacute ward. Journal of Nursing Care Quality, 29(3), 253-262.
Conceptual Framework Describe the theoretical basis for the study	None given	Conceptual framework derived from surveying and Analysing the literature datasets	Not given	None given
Design/Method Describe the design and how the study was carried out	Intervention RCT study	A systematic review of studies	A systematic review of studies	Single cohort study
Sample/Setting The number and characteristics of patients, the attrition rate, etc.	All patients admitted to 24 acute wards	Survey papers	2035 studies published from 2000 to 2014	Patients (n = 34) with cognitive impairment
Major Variables Studied List and define dependent and independent variables	Dependent variable: Fall injuries Independent variable: 6-PACK program	Dependent variable: Fall prevention   Independent variable: Fall-prevention technologies	Dependent variable: Assistance to seniors   Independent variables: Assistive technologies	Dependent variable: f Fall reduction   Independent variable: Electronic sensor bed/chair alarm
Measurement Identify primary statistics used to answer clinical questions	Falls And Fall Injuries Per 1000 Occupied Bed Day	None since the study was a systematic review of previous literature.	None since the study was a systematic review of previous literature.	Electronic sensor alarm feasibility
Data Analysis Statistical or qualitative findings	Descriptive statistic	A systematic review of previous literature on the topic	A systematic review of previous literature on the topic	SPSS Statistics
Findings and Recommendations General findings and recommendations of the research	The study revealed positive changes in the prevention of falls after the introduction of the 6-PACK program.	The study showed the impact of technology-based applications in preventing falls among elderly patients.	The study revealed the effectiveness of assistive technologies in supporting the health outcomes of seniors, including the prevention of falls.	The study revealed that the electronic alarm system is effective, feasible, and acceptable in preventing falls among patients with a cognitive disability.
Appraisal Describe the general worth of this research to practice. What are the strengths and limitations of the study? What are the risks associated with the implementation of the suggested practices or processes detailed in the research? What is the feasibility of use in your practice?	The study provides important information on the role of technology in preventing falls among hospitalized patients. The strength of the study emanates from the aspect that it was performed in a hospital setting. The results are useful in practice.	The systematic review provides adequate evidence to prove the effect of technology in preventing falls among hospitalized elderly patients. The strength emerges from the fact that evidence was obtained from a variety of previous studies.	The study revealed the role of assistive technology in achieving positive health outcomes for the seniors. The evidence was obtained from a variety of previous studies, making it more relevant.	The study provides critical information that reveals how practitioners can use technology to prevent falls among patients with cognitive ailments. The study is reliable because it was a primary cohort study.
General Notes/Comments	The study has reliable and valid information that can be used in practice to create a safe environment for patients and prevent falls and fall-related injuries.	The study provides important evidence from the perspective of various previous studies, which makes it highly objective.	The study provides important evidence from the viewpoint of various previous studies, which makes it highly objective.	The article is a source of best practice in ensuring the effective use of technology in preventing falls among cognitively ill patients.

Levels of Evidence Table

 

Use this document to complete the levels of evidence table requirement of the Module 4 Assessment, Evidence-Based Project, Part 4A: Critical Appraisal of Research

 

 

Author and year of selected article	Barker et al. (2016)	Article #2	Article #3	Article #4
	Barker et al. (2016)	Hamm, Money, Atwal, and Paraskevopoulos (2016)	Khosravi and Ghapanchi (2016)	Shee, Phillips, Hill, and Dodd (2014)
Study Design Theoretical basis for the study	Intervention RCT study	Systematic review of studies	A systematic review of studies	Single cohort study
Sample/Setting The number and characteristics of patients	All patients admitted to 24 acute wards	Survey papers	2035 studies published from 2000 to 2014	Patients (n = 34) with cognitive impairment
Evidence Level * (I, II, or III)	Barker et al. (2016) study is a level I evidence because it is a randomized controlled trial.	Hamm, Money, Atwal, and Paraskevopoulos (2016) study is a level III evidence because it is a systematic review of research.	Khosravi and Ghapanchi (2016) study is a level III evidence because it is a systematic review of research.	Shee, Phillips, Hill, and Dodd (2014) study is a level I evidence because it is an experimental study.
Outcomes	The study revealed positive changes in the prevention of falls after the introduction of the 6-PACK program.	The study showed the impact of technology-based applications in preventing falls among elderly patients.	The study revealed the effectiveness of assistive technologies in supporting the health outcomes of seniors, including the prevention of falls.	The study revealed that the electronic alarm system is effective, feasible, and acceptable in preventing falls among patients with a cognitive disability.
General Notes/Comments	The study has reliable and valid information that can be used in practice to create a safe environment for patients and prevent falls and fall-related injuries.	The study provides important evidence from the perspectives of various previous studies, which makes it highly objective.	The study provides important evidence from the viewpoint of various previous studies, which makes it highly objective.	The article is a source of best practice in ensuring the effective use of technology in preventing falls among cognitively ill patients.

 

* Evidence Levels:

 

• Level I

Experimental, randomized controlled trial (RCT), systematic review RTCs with or without meta-analysis

 

• Level II

Quasi-experimental studies, a systematic review of a combination of RCTs and quasi-experimental studies, or quasi-experimental studies only, with or without meta-analysis

 

• Level III

Nonexperimental, a systematic review of RCTs, quasi-experimental with/without meta-analysis, a qualitative, qualitative systematic review with/without meta-synthesis

• Level IV

Respected authorities’ opinions, nationally recognized expert committee/consensus panel reports based on scientific evidence

• Level V

Literature reviews, quality improvement, program evaluation, financial evaluation, case reports, nationally recognized expert(s) opinion based on experiential evidence

Outcomes Synthesis Table

 

Use this document to complete the outcomes synthesis table requirement of the Module 4 Assessment, Evidence-Based Project, Part 4A: Critical Appraisal of Research

 

 

Author and year of selected article	Barker et al. (2016)	Article #2	Article #3	Article #4
	Barker et al. (2016)	Hamm, Money, Atwal, and Paraskevopoulos (2016)	Khosravi and Ghapanchi (2016)	Shee, Phillips, Hill, and Dodd (2014)
Sample/Setting The number and characteristics of patients	All patients admitted to 24 acute wards	Survey papers	2035 studies published from 2000 to 2014	Patients (n = 34) with cognitive impairment
Outcomes	The study revealed positive changes in the prevention of falls after the introduction of the 6-PACK program.	The study showed the impact of technology-based applications in preventing falls among elderly patients.	The study revealed the effectiveness of assistive technologies in supporting the health outcomes of seniors, including prevention of falls.	The study revealed that the electronic alarm system is effective, feasible, and acceptable in preventing falls among patients with a cognitive disability.
Key Findings	The researchers found out the importance of implementing technology in critical care to prevent falls among patients.	The researchers established the role of technology in preventing falls among elderly patients.	The researchers established the effectiveness of assistive technology in supporting the elderly to lead a positive life, including by preventing falls.	The study revealed that technology such as sensors could be effectively used to prevent falls among cognitively impaired patients.
Appraisal and Study Quality	The study provides important information on the role of technology in preventing falls among hospitalized patients. The strength of the study is that it was performed in a hospital setting. The results are useful in practice.	The systematic review provides adequate evidence to prove the effect of technology in preventing falls among hospitalized elderly patients. The strength emerges from the fact that evidence was obtained from a variety of previous studies.	The study revealed the role of assistive technology in achieving positive health outcomes for the seniors. The strength emerges from the fact that evidence was obtained from a variety of previous studies.	The study provides critical information to show how practitioners can use technology to prevent falls among patients with cognitive ailments. The study is strong because it was a primary cohort study.
General Notes/Comments	The study has reliable and valid information that can be used in practice to create a safe environment for patients and prevent falls and fall-related injuries.	The study provides important evidence from the standpoints of various previous studies, which makes it highly objective.	The study provides critical evidence from the perspectives of various previous studies, which makes it highly objective.	The article is a source of best practice in ensuring the effective use of technology in preventing falls among cognitively ill patients.