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Using a PICO(T) Framework and Evidence to Develop Practices

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Using a PICO(T) Framework and Evidence to Develop Practices

A PICOT is a framework used to provide a good clinical foreground and stands for

Population, Intervention, Comparison, Outcome and Time. Additionally, scholars utilize the

framework to get a go-ahead, and on the right track during research in this assessment, a PICOT

question on falls among the ageing population is explored to determine what is effective in

preventing falls among them in nursing facilities.

PICOT framework Utilization in caring for Elderly people in Nursing Facilities

Research studies have shown that one of the greatest causes of morbidity and disabilities

among the elderly is falling. Notably, falls could also contribute to traumatic brain injury that

mostly shows in later days or sooner after the incident. Most nursing facilities are blamed for the

lack of proper care for elderly people, resulting in too many fall incidents. The many falls

experienced in nursing facilities have led to concerns and questions on how falls could be

prevented in nursing facilities.

PICO (T) question: In elderly people ( Population), how effective are the use of bed and chair

alarms ( Intervention) better compared to video clips (Comparison) in preventing falls (Outcome)

during patient transfer (Time)?

Sources of Evidence

Falls among patients have brought out a heated discussion forcing many scholars to

conduct research and present their distinguished findings and ideas. According to Chan et al.

(2018), few healthcare/nursing institutions lack the best practices for preventing falls. Moreover,

the issue of falls has been discussed at large, and the authors make suggestions on what could be

done to curb the issue. In another article, Chan et al.(2019) the issue of falls is discussed

comprehensively by exploring various aspects such as statistics, types, factors affecting falls and
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what could be done to prevent the issue. Moreover, another article assesses various ways that fall

could be prevented by offering alternatives other than the use of alarms. The rate of falls

incidents seems to be accelerating each year, an outcome that shows that more needs to be done.

Another article shows a study conducted to determine whether alarms effectively prevent patient

falls that mostly occur during transfers. Results indicate that falls could be reduced by the use of

alarms and by preventing unnecessary transfers. Despite the numerous research studies carried

out on injuries related to falls, they continue to increase, and many people are at risk.

Findings and Relevance from Articles

Therw are various ways that patient falls occur. Most patients fall during a transfer from

a bed to a chair, to another bed or from a chair to a bed. Additionally, patients falls in both

hospital and home bathrooms. Both medical practitioners and the patient have roles to play in

preventing falls through coming up with appropriate preventive measures. Whereas the elderly

are at a higher risk of falls, the cognitively impaired elderly patients are at a greater risk of falls

due to their mental health status. Patients that are mentally impaired are likely to move out of the

hospital beds without asking for and form of assistance and their the use of bed and chair alarms

and alerting devices is not fully effective for this particular group of patients. Instead of alarms

and alerting devices, this specific population would be well guides by video clips on how to

safely get put of bed without having to used the hospital bed and chair alarms. Adsitionally,

Chan et al (2019) recommend the use of a more comprehensive care approach of incorporating

skilled nurse practitioners whose main focus would be to work towards preventing and

eradicating patients. This article negatively answers the PICOT question in this case.
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According to Powell-Cope et al. (2016), patient falls result from mostly transfers in

various areas such as wheelchairs to the toilet, among others. The study results showed that

about 26% of falls could be reduced by setting up alarms that patients use to get assistance

whenever they need to move from one place to another. Moreover, falls could be reduced if

transfers were conducted incautiously, especially since most incidents occur when a patient is

being moved from the wheelchair to the bathroom or toilet. Additionally, the health providers

should ensure that the wheelchair is in good condition and reduce unnecessary transfers that put

the patients at a greater risk. The article supports the use of alarms, thus answering our PICOT

questions.

Falls are serious medical concerns that require effective and most appropriate attention.

Health care providers should consider risks, environment and medications regarding falls.

Identifying potential risks helps providers put up measures that hinder falls incidents, such as

medication reviews, footwear, intervention and exercising (Luk et al., 2015).

Conclusion

Our PICOT question on the most appropriate way to deal with falls among the elderly in nursing

homes has been answered. Indeed, many researchers have come up with ideas concerning the

issue of falls, types, statistics and the most appropriate practices to curb the issue. However, most

researchers emphasize that the elderly and cognitively impaired patients are at a greater risk of

falls. In conclusion, we can conclude that in preventing falls among the elderly, bed and chair

alarms are better than video clips in preventing falls during patient transfer. However, the alarms

are not effective on cognitively impaired patients. Perhaps video clips for direction could be

more effective for this particular group.

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References

Chan, D. K., Sherrington, C., Naganathan, V., Xu, Y. H., Chen, J., Ko, A., Kneebone, I., &

Cumming, R. (2018). Key issues to consider and innovative ideas on fall prevention in

the geriatric department of a teaching hospital. Australasian Journal on Ageing, 37(2),

140–143. https://doi-org.library.capella.edu/10.1111/ajag.12528

Chan, D. K. Y., & Chan, L. K. M. (2019). Falls in nursing homes: challenges from a nursing

perspective. British Journal of Community Nursing, 24(1), 6–9.

https://doiorg.library.capella.edu/10.12968/bjcn.2019.24.1.6

Luk, J. K. H., Chan, T. Y., Chan, D. K. Y., & Department of Medicine and Geriatrics, Fung Yiu

King Hospital, Hong Kong. (2015). Falls prevention in the elderly: Translating evidence

into practice. Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi, 21(2), 165.

doi:10.12809/hkmj144469

Powell-Cope, G., Campbell, R., Hahm, B., Bulat, T., & Westphal, J. (2016). Sociotechnical

probabilistic risk modeling to predict injurious falls in community living centers. Journal

of Rehabilitation Research & Development, 53(6), 881–892.

https://doiorg.library.capella.edu/10.1682/JRRD.2015.08.0165