My clinical issue of interest is fall-related injuries in hospitals and how to prevent them. A significant public health issue is falls and injuries brought on by falls. The Prevention of Falls Network for Dissemination (ProFouND) defines a fall as “an unanticipated incident that results in the individual falling to the ground, floor, or a lower level.” The World Health Organization (WHO) estimates that 28–35% of adults over 65 fall at least once each year. In those above 70, this percentage increases to 32-42% (Kenis et al., 2022).
About half of these people experience multiple falls per year. Because biological, environmental, behavioral, and socioeconomic factors are significant, the etiology of falls is complicated (Sam&Lee,2022). Fall accidents can have physical, emotional, and economic repercussions. For instance, significant injuries such as fractures, tissue injuries, or head trauma occur in 5–10% of fall events (Ganz et al., 2022).On a psychological level, it is possible to experience a quality of life decline, social isolation, and fear of falling. Financial implications might also result from falls and injuries caused by falls. In the USA, the direct medical expenses associated with fatal and non-fatal falls are projected to total $50 billion in 2015. These expenses are almost entirely attributed to non-fatal falls. Additionally, the financial toll of falls appears to vary by sex, with older women needing more medical attention than younger ones (Hogan Quigley et al., 2021).
Patient population (P), intervention or issue of interest (I), comparison intervention or problem of interest (C), outcome(s) of interest (O), and time required for the intervention to produce the outcome(s) are the components of the clinical question, abbreviated as PICO(T). The PICOT inquiry is significant because it offers a consistent, organized method for determining the elements of a clinical problem. Clarifying these elements by structuring the clinical question using the PICOT method will assist in directing the search for the information. The likelihood of finding the best evidence to guide practice will rise with a well-constructed PICOT inquiry (Stillwell et al., 2010). From the data I gathered, only some articles could address all the PICOT questions. However, through research from different articles, I found what I needed.
I have used two databases from the Walden library: MEDLINE and CINAHL. At first, when I keyed in fall injuries in the search button, I received 1348 results; using Boolean terms, I added prevention, and the results came down to 577. I further narrowed down and added hospitals; the results finally came to 294. A higher percentage of relevant results can be obtained from searches when Boolean phrases are used to assist in creating them. I can use Boolean operators to make a database search for my PICO (T) inquiry more thorough and effective. The target population or environment can then be specified.
Additionally, I can mention the results of related studies and the precise dates that I would like to appear in my research. For example, Walden wants documents that are less than five years; therefore, I will consider that. Furthermore, I will start my database search with my main thoughts in mind to maximize its effectiveness. I will narrow down and focus on the topic further. For example, in my topic, I can narrow down and choose a specific age group or people from a particular geographical location or with certain underlying conditions; this will help narrow down my search.
References
Ganz, D. A., Yuan, A. H., Greene, E. J., Latham, N. K., Araujo, K., Siu, A. L., Magaziner, J., Gurwitz, J. H., Wu, A. W., Alexander, N. B., Wallace, R. B., Greenspan, S. L., Rich, J., Volpi, E., Waring, S. C., Dykes, P. C., Ko, F., Resnick, N. M., McMahon, S. K., . . . Gill, T. M. (2022). Effect of the STRIDE fall injury prevention intervention on falls, fall injuries, and health‐related quality of life. Journal of the American Geriatrics Society, 70(11), 3221–3229. https://doi.org/10.1111/jgs.17964
Hogan Quigley, B., Renz, S. M., & Bradway, C. (2021). Fall Prevention and Injury Reduction Utilizing Continuous Video Monitoring. Journal of Nursing Care Quality, 37(2), 123–129. https://doi.org/10.1097/ncq.0000000000000582
Kenis, C., Decoster, L., Flamaing, J., Debruyne, P. R., De Groof, I., Focan, C., Cornélis, F., Verschaeve, V., Bachmann, C., Bron, D., Van den Bulck, H., Schrijvers, D., Langenaeken, C., Specenier, P., Jerusalem, G., Praet, J. P., De Cock, J., Lobelle, J. P., Wildiers, H., & Milisen, K. (2022). Incidence of falls and fall-related injuries and their predictive factors in frail older persons with cancer: a multicenter study. BMC Geriatrics, 22(1). https://doi.org/10.1186/s12877-022-03574-7
Sam, P. R., & Lee, P. (2022). Perception: A Critical Analysis of the Hospitalized Patients on Falls. International Journal of Nursing Education, 14(3), 127–130. https://doi.org/10.37506/ijone.v14i3.18365
Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence-Based Practice, Step by Step: Asking the Clinical Question. AJN, American Journal of Nursing, 110(3), 58–61. https://doi.org/10.1097/01.naj.0000368959.11129.79
