Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring

Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring Literature Review Part 1 ( Topic Preventing Fall Using Video Monitoring) While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone project change proposal, the literature review enables students to map out and move into the active planning and development stages of the project. Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Question Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the following sections: Title page Introduction section A comparison of research questions A comparison of sample populations A comparison of the limitations of the study A conclusion section, incorporating recommendations for further research Part 2 Review your strategic plan and determine what resources would be needed if the change proposal were to be implemented. Write a list of at least four resources you will need in order to implement your change proposal. The assignment will be used to develop a written implementation plan. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring rubric_print_format__wk6.xlsx picot_question_paper_week_3.doc literature_evaluation_1.doc Course Code NRS-493 Class Code NRS-493-O503 Criteria Content Percentage 80.0% Literature Review 10.0% Comparison of Research Questions 20.0% Comparison of Sample Populations 20.0% Comparison of the Limitations of the Study 20.0% Conclusion and Recommendations for Further Research 10.0% Organization and Effectiveness 15.0% Thesis Development and Purpose 5.0% Argument Logic and Construction 5.0% Criteria 3Mechanics of Writing (includes spelling, punctuation, grammar, language use) 5.0% Format 5.0% Paper Format (use of appropriate style for the major and assignment) 2.0% Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 3.0% Total Weightage 100% Assignment Title Literature Review 1: Unsatisfactory (0.00%) An introduction is not present. No comparison of research questions is presented. No comparison of sample populations is presented. No comparison of the limitations of the study is presented. No conclusion and recommendations for further research are presented. Paper lacks any discernible overall purpose or organizing claim. Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. Template is not used appropriately or documentation format is rarely followed correctly. Sources are not documented. Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring Total Points 60.0 2: Less Than Satisfactory (75.00%) An introduction is present, but it does not relate to the body of the paper. A comparison of research questions is presented, but it is not valid. A comparison of sample populations is presented, but it is not valid. A comparison of the limitations of the study is presented, but it is not valid. A conclusion and recommendations for further research are presented, but they are not valid. Thesis is insufficiently developed or vague. Purpose is not clear. Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present. Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. 3: Satisfactory (79.00%) An introduction is present, and it relates to the body of the paper. There is nothing in the introduction to entice the reader to continue reading. A cursory though valid comparison of research questions is presented. A cursory though valid comparison of sample populations is presented. A cursory though valid comparison of the limitations of the study is presented. A conclusion and recommendations for further research are valid, but they are cursory. Thesis is apparent and appropriate to purpose. Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring Template is used, and formatting is correct, although some minor errors may be present. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. 4: Good (89.00%) An introduction is present, and it relates to the body of the paper. Information presented in the introduction provides incentive for the reader to continue reading. A moderately thorough and valid comparison of research questions is presented. A moderately thorough and valid comparison of sample populations is presented. A moderately thorough and valid comparison of the limitations of the study is presented. A conclusion and recommendations for further research are valid and moderately thorough. Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used. Template is fully used; There are virtually no errors in formatting style. Sources are documented, as appropriate to assignment and style, and format is mostly correct. 5: Excellent (100.00%) An introduction is present, and it relates to the body of the paper. Information presented in the introduction is intriguing and encourages the reader to continue reading. A reflective and insightful comparison of research questions is presented. A reflective and insightful comparison of sample populations is presented. A reflective and insightful comparison of the limitations of the study is presented. A conclusion and recommendations for further research are reflective and insightful. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. Comments Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. Writer is clearly in command of standard, written, academic English. All format elements are correct. Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. Points Earned Running head: REDUCING PATIENT FALLS PICOT Question Reducing Patient Falls Using Video Monitoring Jacqueline Odquina Grand Canyon University Professional Capstone and Practicum August 08, 2020 1 REDUCING PATIENT FALLS 2 Reducing Patient Falls Using Video Monitoring PICOT Question Among hospitalized patients 65 years and older (P) how does video monitoring (I) compared to standard care (C) affect rates of falls (O) within three months of implementation (T)? Population- hospitalized patients 65 years and older Intervention- Video monitoring Comparison- Standard care Outcomes- Rates of patient falls Time- 3 months Nursing Intervention The proposed nursing intervention is the implementation of video monitoring of patients to reduce the risk of falls. This implementation will include an integrated, central command monitoring system where patient movements and behavior are constantly monitored to determine their risk of fall. The basic protocol would involve a nurse monitoring the video command and addressing the patients using a bedside communication tool. The population considered for this intervention are older in-patients 65 years and older. This is because the risk of falls increases with age (Jin, 2018). Therefore, this age group is a high-risk population when it comes to the issue of falls. The intervention would be compared to standard care that is care without video monitoring for falls. The timeline for this intervention is three months, a timeline considered effective in outlining any significant changes and attributing them to the nursing intervention. REDUCING PATIENT FALLS 3 Clinical Problem and Patient Outcomes Falls occurring to hospitalized patients are a serious health safety problem in the United States. Patients may experience falls due to various aspects including body strength, illness, environment, and frailty. In the country, falls are the major cause of injury-related deaths among patients 65 years and older (Burns & Kakara, 2018). Other than injury-related deaths, falls are connected to prolonged hospital stay, increased costs of care, and poor patient health outcomes (LeLaurin & Shorr, 2019). Nurses are in charge of patient safety during hospital stay. Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring The prevalence and implications of patient falls in the healthcare system thus require evidence-based solutions to be implemented in nursing care to address them. The expected outcomes from this clinical problem is the reduction of patient falls in the healthcare system. As aforementioned, patient falls increase costs and reduce the quality and safety of care delivered to hospitalized patients. Addressing this problem will make the healthcare system safer for older patients and reduce the risk that healthcare systems pose to these patients. The Centers for Medicare & Medicaid Services (CMS) stopped reimbursing healthcare organizations for care costs associated with patient falls (Fehlberg et al., 2017). Falls are thus presented as a healthcare-acquired condition which the hospital must address on its own. Reducing patient falls is, therefore, reduction of hospital acquired conditions. Addressing the problem not only improves patient outcomes but also saves the hospital additional costs. PICOT Problem The PICOT problem of patient falls among elderly in-patients can be viewed in relation to evidence-based solutions, nursing intervention, patient care, health care agency, and nursing practice. In connection to evidence-based solutions, the approach has been tested in several studies and according to Cournan, Fusco-Gessick, and Wright (2018), using video monitoring REDUCING PATIENT FALLS 4 significantly reduces patient falls and costs associated with using patient sitters. Therefore, video monitoring has been implemented in other settings and is an evidence-based solution. In connection to nursing intervention and nursing practice, the PICOT problem demands the implementation of nurse-led interventions using current technology. Video monitoring requires the intervention of healthcare organizations in preparing nurses and providing the relevant equipment. Additionally, nursing practice is impacted by requiring the implementation of specific routine practices to reduce patient falls and improve outcomes of care. Lastly, patient falls affect patient care and health care agencies adversely. When a patient experiences a fall, their health condition is likely to worsen due to injuries caused by the fall. Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring Patient falls thus indicate poor quality patient care. Additionally, with the risk of prolonged hospital stay, patient satisfaction and experience in the healthcare setting are diminished. The health care agency incurs extra costs emanating from patient falls. In addition to costs, rates of falls highlight the safety of the facility and high rates could negatively affect the reputation of the organization. A tainted reputation leads to loss of income for the healthcare organization. In general, patient falls are a great healthcare problem in the US and video monitoring offers the opportunity to reduce their rates and improve quality and safety. REDUCING PATIENT FALLS 5 References Burns, E., & Kakara, R. (2018). Deaths from falls among persons aged? 65 years—United States, 2007–2016. Morbidity and Mortality Weekly Report, 67(18), 509. Cournan, M., Fusco-Gessick, B., & Wright, L. (2018). Improving Patient Safety Through Video Monitoring. Rehabilitation Nursing, 43(2), 111-115. https://doi.org/10.1002/rnj.308 Fehlberg, E. A., Lucero, R. J., Weaver, M. T., McDaniel, A. M., Chandler, M., Richey, P. A., … & Shorr, R. I. (2017). Impact of the CMS no-pay policy on hospital-acquired fall prevention related practice patterns. Innovation in Aging, 1(3), igx036. Jin, J. (2018). Prevention of falls in older adults. Jama, 319(16), 1734-1734. LeLaurin, J. H., & Shorr, R. I. (2019). Preventing falls in hospitalized patients: state of the science. Clinics in Geriatric Medicine, 35(2), 273. Literature Evaluation Table Jacqueline Odquina August 15, 2020 Change Topic (2-3 sentences): Among hospitalized patients 65 years and older (P) how does video monitoring (I) compared to standard care (C) affect rates of falls (O) within three months of implementation (T)? This evidence-based project seeks to determine whether video monitoring of patients can significantly reduce the risk of patient falls. This topic is important because it seeks to reduce the leading cause of injury for elderly patients and significantly improve the safety of hospital settings. Criteria Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article Article 1 Article 2 Cournan, M., FuscoVotruba, L., Graham, B., Gessick, B., & Wright, L. Wisinski, J., & Syed, A. Rehabilitation Nursing Nursing Journal, 43(2), 111-115. Economics, 34(4), 185+. https://doi.org/10.1002/rnj. https://go.gale.com/ps/an 308 onymous?id=GALE%7C A462900201&sid=google Scholar&v=2.1&it=r&linAshford University NRS 493 Reducing Patient Falls Using Video Monitoring kaccess=abs&issn=07461 739&p=AONE&sw=w Article 3 Article 4 Brown Kramer, J., Sabalka, L., Rush, B., Jones, K., & Nolte, T. Proceedings of the IEEE/CVF Conference on Computer Vision and Pattern Recognition Workshops (pp. 294-295). https://openaccess.thecvf.com/co ntent_CVPRW_2020/papers/w1 9/Kramer_Automated_Depth_Vi deo_Monitoring_for_Fall_Reduc tion_A_Case_Study_CVPRW_2 020_paper.pdf Davis, J., Kutash, M., & Whyte IV, J. (2017). Journal of Nursing Education and Practice, 7(3), 137-142. http://dx.doi.org/10.5430/jne p.v7n3p137 © 2015. Grand Canyon University. All Rights Reserved. Article Title and Year Published Video monitoring to reduce falls and patient companion costs for adult inpatients (2016) Improving patient safety through video monitoring (2018) Automated Depth Video Monitoring for Fall Reduction: A Case Study (2020) A comparative study of patient sitters with video monitoring versus in-room sitters (2017) Research Questions (Qualitative)/Hypo thesis (Quantitative) The introduction of video monitoring reduces the rates of falls. Video monitoring is effective in reducing patient falls. A system that creates computer vision of patients’ beds can be used to reduce the rates of falls. The combination of in-room sitters and video monitoring reduces the rates of falls in hospitals. Purposes/Aim of Study To propose the use of video monitoring as a safe and reliable tool for reducing patient falls. To determine the effectiveness of a video monitoring intervention for reduction of patient falls. To reduce the rates of patient falls using a video monitoring application. Design (Type of Quantitative, or Type of Qualitative) Quantitative- Quasiexperimental study Quantitative- sequential cohort design, an experimental study Quantitative- Quasiexperimental study To determine the prevalence of patient falls and self-harm using in-room sitters and video monitoring and associated costs. Quantitative- quasiexperimental approach Setting/Sample Single-center convenience sampling 115?bed Inpatient Rehabilitation Facility 13 hospitals in the United States Methods: Intervention/Instr uments Quasi-experimental: An intervention using videos and bedside sitter was implemented Pre and post-intervention analyses of rates of falls Total fall rates were tracked before and after installation of video monitoring units Total fall rates were tracked before and after installation of video monitoring units Statistical analysis of rates of falls pre and postimplementation Rates of falls were 6.34 per 1,000 patient?days and a year after implementation of the program reduced to 5.099 falls per 1,000 Statistical analysis of rates of falls pre and postimplementation There was a significant reduction of the rates of falls in all 13 hospitals Analysis Key Findings Video monitoring has a 35% reduction in falls compared to the presence of a sitter © 2017. Grand Canyon University. Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring All Rights Reserved. Nonrandomized consecutive sample in a West Central Florida teaching facility Monthly basis data collection on rates of falls of patients Descriptive statistics and independent samples t tests were performed Although there was no statistically significant reduction in rates of patient falls, video monitoring was found to be less expensive patient?days Recommendations Explanation of How the Article Supports EBP/Capstone Project Video monitoring is safe and effective in reducing rates of falls and should be applied. The article compares the intervention and comparison groups in the PICOT question hence providing evidence that the suggested intervention is effective. than using sitters Video monitoring produces statistically significant decrease in rates of falls The video monitoring application is effective in reducing rates of falls Video monitoring should be used to reduce the costs of reducing patient falls The study presents evidence of effectiveness of video monitoring hence suggesting the use of the intervention in reducing patient falls The use of video monitoring application is an applicationspecific analysis of the intervention in the capstone project hence supporting the suggested intervention. The article looks into the cost and safety of video monitoring and recommends it on the basis of reducing costs of patient falls Criteria Article 5 Author, Journal (PeerReviewed), and Permalink or Working Link to Access Article Sand-Jecklin, K., Johnson, J. R., & Tylka, S. Journal of Nursing Care Quality, 31(2), 131-138. https://doi.org/10.1097/NC Q.0000000000000163 Klymko, K., Etcher, L., Munchiando, J., & Royse, M. Medsurg Nursing, 25(5), 329. https://search.proquest.com/open view/505fbd74edb3022f04f8031e d9311bda/1?pqorigsite=gscholar&cbl=30764 King, B., Pecanac, K., Krupp, A., Liebzeit, D., & Mahoney, J. The Gerontologist, 58(2), 331340. https://doi.org/10.1093/geront/g nw156 Sand-Jecklin, K., Johnson, J., Tringhese, A., Daniels, C., & White, F. Journal of Nursing Care Quality, 34(2), 145-150. https://doi.org/10.1097/NC Q.0000000000000355 Article Title and Year Published Protecting patient safety: Can video monitoring prevent falls in high-risk patient populations? (2016) Can video monitoring prevent falls in high-risk patient populations? Video monitoring: a room with a view, or a window to challenges in falls prevention research? (2016) Impact of fall prevention on nurses and care of fall risk patients (2018) Video monitoring for fall prevention and patient safety: process evaluation and improvement (2019) (a) How are the antecedents to a preventable fall in patient rooms on a medical unit described? (b) How does the “zero falls” initiative driven by the Center for Medicare and Medicaid How can video monitoring best practices be implemented to enhance Research Questions (Qualitative)/H Article 6 Article 7 © 2017. Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring Grand Canyon University. All Rights Reserved. Article 8 ypothesis (Quantitative) How do the identified antecedents appear on the screen to a VM technician monitoring patients on a medical unit? (c) What are the environmental conditions and patient behaviors that should precipitate fall prevention action during VM? To explore antecedents to falls in the acute care setting. (CMS) affect the experiences of nurses in prevention of patient falls? its effectiveness? To explore nurses’ experiences in fall prevention in hospital settings. To evaluate the monitoring process at a large teaching hospital, with the goal of making improvements and standardizing monitoring practices. Phenomenological qualitative study Purposes/Aim of Study To study the feasibility of a video monitoring system to reduce rates of falls. Design (Type of Quantitative, or Type of Qualitative) Narrative qualitative study Phenomenological qualitative study Qualitative Grounded Dimensional Analysis (GDA) Setting/Sample A large teaching hospital Single rehabilitation hospital Methods: Intervention/I nstruments Analysis of the feasibility of the system given the hospital env … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring

Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring Literature Review Part 1 ( Topic Preventing Fall Using Video Monitoring) While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone project change proposal, the literature review enables students to map out and move into the active planning and development stages of the project. Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Question Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the following sections: Title page Introduction section A comparison of research questions A comparison of sample populations A comparison of the limitations of the study A conclusion section, incorporating recommendations for further research Part 2 Review your strategic plan and determine what resources would be needed if the change proposal were to be implemented. Write a list of at least four resources you will need in order to implement your change proposal. The assignment will be used to develop a written implementation plan. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring rubric_print_format__wk6.xlsx picot_question_paper_week_3.doc literature_evaluation_1.doc Course Code NRS-493 Class Code NRS-493-O503 Criteria Content Percentage 80.0% Literature Review 10.0% Comparison of Research Questions 20.0% Comparison of Sample Populations 20.0% Comparison of the Limitations of the Study 20.0% Conclusion and Recommendations for Further Research 10.0% Organization and Effectiveness 15.0% Thesis Development and Purpose 5.0% Argument Logic and Construction 5.0% Criteria 3Mechanics of Writing (includes spelling, punctuation, grammar, language use) 5.0% Format 5.0% Paper Format (use of appropriate style for the major and assignment) 2.0% Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 3.0% Total Weightage 100% Assignment Title Literature Review 1: Unsatisfactory (0.00%) An introduction is not present. No comparison of research questions is presented. No comparison of sample populations is presented. No comparison of the limitations of the study is presented. No conclusion and recommendations for further research are presented. Paper lacks any discernible overall purpose or organizing claim. Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. Template is not used appropriately or documentation format is rarely followed correctly. Sources are not documented. Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring Total Points 60.0 2: Less Than Satisfactory (75.00%) An introduction is present, but it does not relate to the body of the paper. A comparison of research questions is presented, but it is not valid. A comparison of sample populations is presented, but it is not valid. A comparison of the limitations of the study is presented, but it is not valid. A conclusion and recommendations for further research are presented, but they are not valid. Thesis is insufficiently developed or vague. Purpose is not clear. Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present. Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. 3: Satisfactory (79.00%) An introduction is present, and it relates to the body of the paper. There is nothing in the introduction to entice the reader to continue reading. A cursory though valid comparison of research questions is presented. A cursory though valid comparison of sample populations is presented. A cursory though valid comparison of the limitations of the study is presented. A conclusion and recommendations for further research are valid, but they are cursory. Thesis is apparent and appropriate to purpose. Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring Template is used, and formatting is correct, although some minor errors may be present. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. 4: Good (89.00%) An introduction is present, and it relates to the body of the paper. Information presented in the introduction provides incentive for the reader to continue reading. A moderately thorough and valid comparison of research questions is presented. A moderately thorough and valid comparison of sample populations is presented. A moderately thorough and valid comparison of the limitations of the study is presented. A conclusion and recommendations for further research are valid and moderately thorough. Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used. Template is fully used; There are virtually no errors in formatting style. Sources are documented, as appropriate to assignment and style, and format is mostly correct. 5: Excellent (100.00%) An introduction is present, and it relates to the body of the paper. Information presented in the introduction is intriguing and encourages the reader to continue reading. A reflective and insightful comparison of research questions is presented. A reflective and insightful comparison of sample populations is presented. A reflective and insightful comparison of the limitations of the study is presented. A conclusion and recommendations for further research are reflective and insightful. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. Comments Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. Writer is clearly in command of standard, written, academic English. All format elements are correct. Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. Points Earned Running head: REDUCING PATIENT FALLS PICOT Question Reducing Patient Falls Using Video Monitoring Jacqueline Odquina Grand Canyon University Professional Capstone and Practicum August 08, 2020 1 REDUCING PATIENT FALLS 2 Reducing Patient Falls Using Video Monitoring PICOT Question Among hospitalized patients 65 years and older (P) how does video monitoring (I) compared to standard care (C) affect rates of falls (O) within three months of implementation (T)? Population- hospitalized patients 65 years and older Intervention- Video monitoring Comparison- Standard care Outcomes- Rates of patient falls Time- 3 months Nursing Intervention The proposed nursing intervention is the implementation of video monitoring of patients to reduce the risk of falls. This implementation will include an integrated, central command monitoring system where patient movements and behavior are constantly monitored to determine their risk of fall. The basic protocol would involve a nurse monitoring the video command and addressing the patients using a bedside communication tool. The population considered for this intervention are older in-patients 65 years and older. This is because the risk of falls increases with age (Jin, 2018). Therefore, this age group is a high-risk population when it comes to the issue of falls. The intervention would be compared to standard care that is care without video monitoring for falls. The timeline for this intervention is three months, a timeline considered effective in outlining any significant changes and attributing them to the nursing intervention. REDUCING PATIENT FALLS 3 Clinical Problem and Patient Outcomes Falls occurring to hospitalized patients are a serious health safety problem in the United States. Patients may experience falls due to various aspects including body strength, illness, environment, and frailty. In the country, falls are the major cause of injury-related deaths among patients 65 years and older (Burns & Kakara, 2018). Other than injury-related deaths, falls are connected to prolonged hospital stay, increased costs of care, and poor patient health outcomes (LeLaurin & Shorr, 2019). Nurses are in charge of patient safety during hospital stay. Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring The prevalence and implications of patient falls in the healthcare system thus require evidence-based solutions to be implemented in nursing care to address them. The expected outcomes from this clinical problem is the reduction of patient falls in the healthcare system. As aforementioned, patient falls increase costs and reduce the quality and safety of care delivered to hospitalized patients. Addressing this problem will make the healthcare system safer for older patients and reduce the risk that healthcare systems pose to these patients. The Centers for Medicare & Medicaid Services (CMS) stopped reimbursing healthcare organizations for care costs associated with patient falls (Fehlberg et al., 2017). Falls are thus presented as a healthcare-acquired condition which the hospital must address on its own. Reducing patient falls is, therefore, reduction of hospital acquired conditions. Addressing the problem not only improves patient outcomes but also saves the hospital additional costs. PICOT Problem The PICOT problem of patient falls among elderly in-patients can be viewed in relation to evidence-based solutions, nursing intervention, patient care, health care agency, and nursing practice. In connection to evidence-based solutions, the approach has been tested in several studies and according to Cournan, Fusco-Gessick, and Wright (2018), using video monitoring REDUCING PATIENT FALLS 4 significantly reduces patient falls and costs associated with using patient sitters. Therefore, video monitoring has been implemented in other settings and is an evidence-based solution. In connection to nursing intervention and nursing practice, the PICOT problem demands the implementation of nurse-led interventions using current technology. Video monitoring requires the intervention of healthcare organizations in preparing nurses and providing the relevant equipment. Additionally, nursing practice is impacted by requiring the implementation of specific routine practices to reduce patient falls and improve outcomes of care. Lastly, patient falls affect patient care and health care agencies adversely. When a patient experiences a fall, their health condition is likely to worsen due to injuries caused by the fall. Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring Patient falls thus indicate poor quality patient care. Additionally, with the risk of prolonged hospital stay, patient satisfaction and experience in the healthcare setting are diminished. The health care agency incurs extra costs emanating from patient falls. In addition to costs, rates of falls highlight the safety of the facility and high rates could negatively affect the reputation of the organization. A tainted reputation leads to loss of income for the healthcare organization. In general, patient falls are a great healthcare problem in the US and video monitoring offers the opportunity to reduce their rates and improve quality and safety. REDUCING PATIENT FALLS 5 References Burns, E., & Kakara, R. (2018). Deaths from falls among persons aged? 65 years—United States, 2007–2016. Morbidity and Mortality Weekly Report, 67(18), 509. Cournan, M., Fusco-Gessick, B., & Wright, L. (2018). Improving Patient Safety Through Video Monitoring. Rehabilitation Nursing, 43(2), 111-115. https://doi.org/10.1002/rnj.308 Fehlberg, E. A., Lucero, R. J., Weaver, M. T., McDaniel, A. M., Chandler, M., Richey, P. A., … & Shorr, R. I. (2017). Impact of the CMS no-pay policy on hospital-acquired fall prevention related practice patterns. Innovation in Aging, 1(3), igx036. Jin, J. (2018). Prevention of falls in older adults. Jama, 319(16), 1734-1734. LeLaurin, J. H., & Shorr, R. I. (2019). Preventing falls in hospitalized patients: state of the science. Clinics in Geriatric Medicine, 35(2), 273. Literature Evaluation Table Jacqueline Odquina August 15, 2020 Change Topic (2-3 sentences): Among hospitalized patients 65 years and older (P) how does video monitoring (I) compared to standard care (C) affect rates of falls (O) within three months of implementation (T)? This evidence-based project seeks to determine whether video monitoring of patients can significantly reduce the risk of patient falls. This topic is important because it seeks to reduce the leading cause of injury for elderly patients and significantly improve the safety of hospital settings. Criteria Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article Article 1 Article 2 Cournan, M., FuscoVotruba, L., Graham, B., Gessick, B., & Wright, L. Wisinski, J., & Syed, A. Rehabilitation Nursing Nursing Journal, 43(2), 111-115. Economics, 34(4), 185+. https://doi.org/10.1002/rnj. https://go.gale.com/ps/an 308 onymous?id=GALE%7C A462900201&sid=google Scholar&v=2.1&it=r&linAshford University NRS 493 Reducing Patient Falls Using Video Monitoring kaccess=abs&issn=07461 739&p=AONE&sw=w Article 3 Article 4 Brown Kramer, J., Sabalka, L., Rush, B., Jones, K., & Nolte, T. Proceedings of the IEEE/CVF Conference on Computer Vision and Pattern Recognition Workshops (pp. 294-295). https://openaccess.thecvf.com/co ntent_CVPRW_2020/papers/w1 9/Kramer_Automated_Depth_Vi deo_Monitoring_for_Fall_Reduc tion_A_Case_Study_CVPRW_2 020_paper.pdf Davis, J., Kutash, M., & Whyte IV, J. (2017). Journal of Nursing Education and Practice, 7(3), 137-142. http://dx.doi.org/10.5430/jne p.v7n3p137 © 2015. Grand Canyon University. All Rights Reserved. Article Title and Year Published Video monitoring to reduce falls and patient companion costs for adult inpatients (2016) Improving patient safety through video monitoring (2018) Automated Depth Video Monitoring for Fall Reduction: A Case Study (2020) A comparative study of patient sitters with video monitoring versus in-room sitters (2017) Research Questions (Qualitative)/Hypo thesis (Quantitative) The introduction of video monitoring reduces the rates of falls. Video monitoring is effective in reducing patient falls. A system that creates computer vision of patients’ beds can be used to reduce the rates of falls. The combination of in-room sitters and video monitoring reduces the rates of falls in hospitals. Purposes/Aim of Study To propose the use of video monitoring as a safe and reliable tool for reducing patient falls. To determine the effectiveness of a video monitoring intervention for reduction of patient falls. To reduce the rates of patient falls using a video monitoring application. Design (Type of Quantitative, or Type of Qualitative) Quantitative- Quasiexperimental study Quantitative- sequential cohort design, an experimental study Quantitative- Quasiexperimental study To determine the prevalence of patient falls and self-harm using in-room sitters and video monitoring and associated costs. Quantitative- quasiexperimental approach Setting/Sample Single-center convenience sampling 115?bed Inpatient Rehabilitation Facility 13 hospitals in the United States Methods: Intervention/Instr uments Quasi-experimental: An intervention using videos and bedside sitter was implemented Pre and post-intervention analyses of rates of falls Total fall rates were tracked before and after installation of video monitoring units Total fall rates were tracked before and after installation of video monitoring units Statistical analysis of rates of falls pre and postimplementation Rates of falls were 6.34 per 1,000 patient?days and a year after implementation of the program reduced to 5.099 falls per 1,000 Statistical analysis of rates of falls pre and postimplementation There was a significant reduction of the rates of falls in all 13 hospitals Analysis Key Findings Video monitoring has a 35% reduction in falls compared to the presence of a sitter © 2017. Grand Canyon University. Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring All Rights Reserved. Nonrandomized consecutive sample in a West Central Florida teaching facility Monthly basis data collection on rates of falls of patients Descriptive statistics and independent samples t tests were performed Although there was no statistically significant reduction in rates of patient falls, video monitoring was found to be less expensive patient?days Recommendations Explanation of How the Article Supports EBP/Capstone Project Video monitoring is safe and effective in reducing rates of falls and should be applied. The article compares the intervention and comparison groups in the PICOT question hence providing evidence that the suggested intervention is effective. than using sitters Video monitoring produces statistically significant decrease in rates of falls The video monitoring application is effective in reducing rates of falls Video monitoring should be used to reduce the costs of reducing patient falls The study presents evidence of effectiveness of video monitoring hence suggesting the use of the intervention in reducing patient falls The use of video monitoring application is an applicationspecific analysis of the intervention in the capstone project hence supporting the suggested intervention. The article looks into the cost and safety of video monitoring and recommends it on the basis of reducing costs of patient falls Criteria Article 5 Author, Journal (PeerReviewed), and Permalink or Working Link to Access Article Sand-Jecklin, K., Johnson, J. R., & Tylka, S. Journal of Nursing Care Quality, 31(2), 131-138. https://doi.org/10.1097/NC Q.0000000000000163 Klymko, K., Etcher, L., Munchiando, J., & Royse, M. Medsurg Nursing, 25(5), 329. https://search.proquest.com/open view/505fbd74edb3022f04f8031e d9311bda/1?pqorigsite=gscholar&cbl=30764 King, B., Pecanac, K., Krupp, A., Liebzeit, D., & Mahoney, J. The Gerontologist, 58(2), 331340. https://doi.org/10.1093/geront/g nw156 Sand-Jecklin, K., Johnson, J., Tringhese, A., Daniels, C., & White, F. Journal of Nursing Care Quality, 34(2), 145-150. https://doi.org/10.1097/NC Q.0000000000000355 Article Title and Year Published Protecting patient safety: Can video monitoring prevent falls in high-risk patient populations? (2016) Can video monitoring prevent falls in high-risk patient populations? Video monitoring: a room with a view, or a window to challenges in falls prevention research? (2016) Impact of fall prevention on nurses and care of fall risk patients (2018) Video monitoring for fall prevention and patient safety: process evaluation and improvement (2019) (a) How are the antecedents to a preventable fall in patient rooms on a medical unit described? (b) How does the “zero falls” initiative driven by the Center for Medicare and Medicaid How can video monitoring best practices be implemented to enhance Research Questions (Qualitative)/H Article 6 Article 7 © 2017. Ashford University NRS 493 Reducing Patient Falls Using Video Monitoring Grand Canyon University. All Rights Reserved. Article 8 ypothesis (Quantitative) How do the identified antecedents appear on the screen to a VM technician monitoring patients on a medical unit? (c) What are the environmental conditions and patient behaviors that should precipitate fall prevention action during VM? To explore antecedents to falls in the acute care setting. (CMS) affect the experiences of nurses in prevention of patient falls? its effectiveness? To explore nurses’ experiences in fall prevention in hospital settings. To evaluate the monitoring process at a large teaching hospital, with the goal of making improvements and standardizing monitoring practices. Phenomenological qualitative study Purposes/Aim of Study To study the feasibility of a video monitoring system to reduce rates of falls. Design (Type of Quantitative, or Type of Qualitative) Narrative qualitative study Phenomenological qualitative study Qualitative Grounded Dimensional Analysis (GDA) Setting/Sample A large teaching hospital Single rehabilitation hospital Methods: Intervention/I nstruments Analysis of the feasibility of the system given the hospital env … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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