• Type of paperResearch Paper
  • SubjectNursing
  • Number of pages6
  • Format of citationAPA
  • Number of cited resources4
  • Type of serviceWriting

Overview Schedule an interview with a (1) family based on personal/professional acquaintance, to complete a comprehensive, written assessment/analysis using the criteria listed below (based on class notes and readings). DO NOT use your family of orientation (family of origin) or your nuclear (conjugal) family. (For definitions, see the Glossary of Terms in Friedman et al, Family Nursing textbook. Note: Please follow the attached rubric for this assignment. Thank you.


N4325 Nursing Research

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Submit by the due date and time listed in your syllabus.

Overview

This assignment will allow you to create an evidence-based practice project that includes the development of a PICO question and follows the initial steps of the Iowa Model. You will share your findings using an APA formatted paper.

Submitting your assignment

· Save this document to your desktop as a Word document.

· Open the document from your desktop and review the assignment instructions and grading rubric.

· Create a separate Word document for your paper.

· Return to Blackboard and upload your paper and your nursing research article that was approved by your coach in Module 2 to the assignment submission link in Module Four. Please note: if you forget to upload your nursing quantitative research article, a 5 point penalty will be applied to your paper.

Grading Rubric

Use this rubric to guide your work the assignment. Points are awarded for each section based on content and clarity of expression.



Accomplished

(Maximum points awarded)

Proficient

(Points awarded based on content)

Needs Improvement

(Minimum points awarded)

Initial PICO question completed / nursing research article selected.



Research article is a quantitative article, nursing focused, and is 5 years or less from current publication date.

Please note: if you forget to upload your nursing quantitative research article, a 5 point penalty will be applied to your paper

5 – 4 points

Research article is a quantitative article that is nursing focused but is greater than 5 years old.

3 – 2 points

Research article is not nursing focused or is a qualitative article, systematic review, meta-synthesis, meta-analysis, meta-summary, integrative review, clinical information article or “how-to” article.

No article uploaded.

0 points

Opening Paragraph

(Paragraph #1)

Introduction statement(s) present.

PICO question with all elements present.

Statement of importance with two facts such as costs, morbidity, mortality, safety. Include related statistics with citation and is 5 years or less from current publication date.

10 – 9 points

No introduction statement(s).

PICO statement is incomplete.

Statement of importance incomplete or missing.

Citation is incomplete or missing.

8 – 3 points

PICO(T) Worksheet


First, identify each element of your PICO on the line below, then take a look at the templates below to help you formulate a PICO(T) question.

P: Population/disease ( i.e. age, gender, ethnicity, with a certain disorder)

P: ____________________________________________________________________

I: Intervention or Variable of Interest (exposure to a disease, risk behavior, prognostic factor) Note: Not every question will have an intervention (as in a meaning question – see below).

I: ____________________________________________________________________

C: Comparison: (could be a placebo or “business as usual” as in no disease, absence of risk factor). Note: This is not used in a meaning question – see below.

C: ____________________________________________________________________

O: Outcome: (risk of disease, accuracy of a diagnosis, rate of occurrence of adverse outcome)

O: ____________________________________________________________________


T:

Time: The time it takes to demonstrate an outcome (e.g. the time it takes for the intervention to achieve an outcome or how long participants are observed). This is an optional “add-on” for a PICO question.




~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

For PICO questions about a nursing intervention/therapy:

In _______(P), what is the effect of _______(I) on ______(O) compared with _______(C) within ________ (T)?

For PICO etiology questions:

Are ____ (P) who have _______ (I) at ___ (increased/decreased) risk for/of_______ (O) compared with ______ (P) with/without ______ (C) over _____ (T)?

For PICO questions involving prevention:

For ________ (P) does the use of ______ (I) reduce the future risk of ________ (O) compared with _________ (C)?

For PICO questions that predict:

Does __________ (I) influence ________ (O) in patients who have _______ (P) over ______ (T)?

For PICO questions that want to know more about the meaning of…..

How do ________ (P) diagnosed with _______ (I) perceive ______ (O) during _____ (T)?

Based on Melnyk B., & Fineout-Overholt E. (2010). Evidence-based practice in nursing & healthcare. New York: Lippincott Williams & Wilkins.

Stock Epinephrine 1

Running head: STOCK EPINEPHRINE AUTO-INJECTORS IN SCHOOLS

Stock Epinephrine Auto-Injectors in Schools

Fantastic RN-BSN Student

The University of Texas Arlington

College of Nursing and Health Innovation

In partial fulfillment of the requirements of

N4325 Nursing Research

Regina Urban, MSN, RN-BC, CCRN

February 13, 2015

2

STOCK EPINEPHRINE AUTO-INJECTORS IN SCHOOLS

Stock Epinephrine Auto-Injectors in Schools

With the increasing rise in food allergies that can be potentially life threatening, it is

becoming extremely important that schools be prepared to handle such emergency situations.

Among school age children, 1 in 25 students has a food allergy and 30-50% of those allergies

will induce an anaphylaxis emergency (Zacharski, DeSisto, Pontius, Sheets, & Richesin, 2012).

What is scary is that these are statistics of children with known food allergies. However, it is

estimated that 25% of students that have an anaphylactic reaction had previously no known

allergies (Zacharski et al., 2012). In dealing with anaphylactic emergencies, it is the schools

responsibility to plan and be prepared to handle situations. The school nurse takes the lead in

managing student’s health needs, educating school staff, and providing a safe learning

environment for students (Zacharski et al., 2012). So, does the presence of stock epinephrine

auto injectors in schools reduce the complications school age students experience in the event of

an anaphylactic emergency?

In a research study, California school nurses were surveyed to determine “experience

with life-threatening anaphylaxis, implementation of allowable stock epinephrine auto-injector

programs, and barriers to program implementation” (Morris, Baker, Belot, &Edwards, 2011, pp.

471-472). Some interesting facts that the article presented included that 73% of the school

nurses reported that they had student with known allergies in their schools with 52% of those

nurses having students that can self-carry their epinephrine auto-injectors (Morris et al., 2011).

Additionally, 30% of the school nurses surveyed had at one time used another student’s

prescribed rescue medication for the use on another student during an emergency (Morris et al.,

2011). Lastly, 72% of the school nurses reported that there were students in their schools that

had known allergies or previous use of epinephrine who had parents that di

271
Vaccari E, Lenardt MH, Willig MH, Betiolli SE, Oliveira ES.Safety of the hospital environment in terms of preventing falls on the
part of the elderly: a descriptive study. Online braz j nurs [internet] 2014 Sep [cited year month day]; 13 (3):271-81. Available
from: http://www.objnursing.uff.br/index.php/nursing/article/view/4753

ISSN: 1676-4285

271

Safety of the hospital environment in
terms of preventing falls on the part
of the elderly: a descriptive study
Élide Vaccari1, Maria Helena Lenardt1, Mariluci Hautsch Willig1,
Susanne Elero Betiolli1, Edinaldo Silva de Oliveira2

1 Paraná Federal University
2 Federal University of Paraná

ABSTRACT
Aim: To evaluate the safety of the individual and collective physical environment to prevent falls on the part
of the hospitalized elderly. Method: This is a descriptive cross-sectional and quantitative study. A total of
one hundred and twenty seven (127) beds and their physical structure were evaluated in three units. Data
were collected by means of a checklist. For analysis, the SPSS v.20.0 software was used, and descriptive
statistics was employed as well as the Fisher’s exact test for any association between the variables. Results:
safety variables related to the movement of individuals showed a lack of compliance with safety standards
(77.7%), and showed no statistical significance with regard to the incidence of falls. The physical structure
of the public areas of the hospital were not adapted to facilitate the movement of persons (42.8%) and little
consideration had been given to other health facilities (66.6%). Discussion: It is necessary to pay attention to
non-conformities in order to decrease the risk of falling. Conclusion: It is necessary to ensure that the hospital
environment adheres to technical standards and that the nursing staff pays attention to the environment in
order to ensure safety and to prevent falls on the part of the elderly.

Descriptors: Accidental Falls; Geriatric Nursing; Health Facility Environment.

272
Vaccari E, Lenardt MH, Willig MH, Betiolli SE, Oliveira ES.Safety of the hospital environment in terms of preventing falls on the
part of the elderly: a descriptive study. Online braz j nurs [internet] 2014 Sep [cited year month day]; 13 (3):271-81. Available
from: http://www.objnursing.uff.br/index.php/nursing/article/view/4753

INTRODUCTION

Several factors inherent to the aging pro-
cess may cause a progressive loss of ability on
the part of the elderly in adapting to their envi-
ronment, especially in terms of changing loca-
tion, such as in a hospital. Thus, the evaluation
of the environment of the patient is essential to
develop strategies to help prevent falls.

Thinking about safe areas in which the el-
derly spend the majority of their time is a major
challenge. A closer look is necessary since

Patient Safety

PercePtions related to
Falls and Fall Prevention
among HosPitalized
adults
By Renee Samples Twibell, RN, PhD, CNE, Debra Siela, RN, PhD, CCNS, ACNS-BC,
CCRN-K, CNE, RRT, Terrie Sproat, RN, BS, and Gena Coers, RN, BS

©2015 American Association of Critical-Care Nurses
doi: http://dx.doi.org/10.4037/ajcc2015375

Background Prevention of falls during hospitalization
depends in part on the behaviors of alert patients to
prevent falls. Research on acutely ill patients’ intentions
to behave in ways that help prevent falls and on the
patients’ perceptions related to falls is limited.
Objective To explore hospitalized adults’ perceptions
related to risk for falling, fear of falling, expectations of
outcomes of falling, and intention to engage in behaviors
to prevent falls.
Methods Adult, alert, acutely ill inpatients (N = 158) at
risk for falling completed a survey consisting of 4 scales
and 3 single items. Nurses’ assessments and patients’
perceptions of the risk for falling were compared.
Results Decreased intentions to engage in behaviors
to prevent falls were correlated with patients’ increased
confidence in their ability to perform high-risk behaviors
without help and without falling (P < .001), decreased fear
of falling (P < .001), and decreased perceived likelihood
of adverse outcomes if they did fall (P < .001). Although
nurses’ assessments indicated a risk for falls, 55.1% of
the patients did not perceive a high likelihood of falling
while hospitalized. Whereas 75% of patients intended to
ask for help before getting out of bed, 48% were con-
fident that they could get out of bed without help and
without falling.
Conclusions Although assessments may indicate a risk
for falling, acutely ill inpatients may not perceive they are
likely to fall. Patients’ intentions to engage in behaviors
to prevent falls vary with the patients’ fall-related percep-
tions of confidence, outcomes, and fear related to falling.
(American Journal of Critical Care. 2015;24:e78-e85)

e78 AJCC AMERICAN JOURNAL OF CRITICAL CARE, September 2015, Volume 24, No. 5 www.ajcconline.org

F
alls are the most common adverse event among hospitalized patients, directly contrib-
uting to human pain and distress and increased health care costs.1-9 Complications asso-
ciated with falls among hospitalized patients can result in death, disability, increased
hospital length of stay, placement in an extended care facility, psychological distress,
and litigation.1,4,10-13 In addition, the cost of falls in the United States may be more than

$40 billion by 2020.2,9,14 Researchers have clearly identified factors related to falls15-25 and inter-
ventions that reduce falls.1,12,18-23,26-34 Yet, falls continue to be a serious safety threat, especially
for acutely ill, hospitalized patients.2,5-8,16,17,19,20,

Running head: HOSPITALIZED PATIENT PERCEPTION ON FALL RISKS
1

Hospitalized Patient Perception on Fall Risks and Prevention

Assessment and Intervention of Patient Perceptions on Fall Risks

The University of Texas at Arlington College of Nursing and Health Innovation

Hospitalized Patient Perception on Fall Risks and Prevention

Assessment and Intervention of Patient Perceptions on Fall Risks

Hospitalized adults are more prone to falling during acute hospitalizations for a number of reasons. Acuity of illness, history of falls, clinical presentation such as confusion, unfamiliar environment, medications, age, mobility, gait, strength, physiological impairments and medical equipment, tubes, and lines directly contribute to an increase risk of falls along with other factors. Part of the nursing assessment is to assess the risk for falls and implement nursing interventions to prevent these from occurring. Regardless of nursing assessments and interventions, “hundreds of thousands of patients fall in hospitals, with 30-50% resulting in injury,” prolonging hospitalization time for an additional “average cost of $14,000” (The Joint Commission, 2015). Although not all falls result in injury, “falls with serious injury are consistently among the Top 10 sentinel events reported to The Joint Commission’s Sentinel Event database” with 63% “reported falls with injuries since 2009” resulting in death (The Joint Commission, 2015). When assessing patients for fall risks, however, patient perception on fall risks are not commonly assessed or addressed. In order to attempt to understand patient behavior, and involvement in care in regards to fall prevention patient perception should be assessed. For alert acutely-ill hospitalized adults, does the use of nursing fall risk assessments in combination with assessment of patient perceptions on falls, decrease the incidence of falls by promoting patient involvement in fall prevention?

A research study conducted at Indiana University Health Ball Memorial Hospital surveyed 158 acutely-ill hospitalized consenting patients using a 38 item survey measuring confidence, fear, consequences and patient intent for engagement related to falls. Using the Intention Scale, “more than 75% of a participants reported they would call for assistance before getting out of bed” (Twibell, Siela, Sproat, & Coers, 2015). Fall prevention is the responsibility of both the nurse and patient, therefore patient engagement in their safety by working with the nurse and staff can decrease the incidence of falls. Although it is undetermined if the percentage is accurate due to the survey increasing patient’s exposure to the risk of falls, this information can be used to further assess the patient perception post fall prevention education. A relationship between patient perceived fall risk and anticipation of fall outcomes was identified. Patient anticipat

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CONTENTS

1 Introduction to Nursing Research
and Evidence-Based Practice, 1

2 Introduction to Quantitative Research, 31

3 Introduction to Qualitative Research, 66

4 Examining Ethics in Nursing Research, 93

5 Research Problems, Purposes, and Hypotheses, 129

6 Understanding and Critically Appraising
the Literature Review, 162

7 Understanding Theory and Research Frameworks, 189

8 Clarifying Quantitative Research Designs, 210

9 Examining Populations and Samples in Research, 248

10 Clarifying Measurement and Data Collection
in Quantitative Research, 281

11 Understanding Statistics in Research, 317

12 Critical Appraisal of Quantitative and Qualitative
Research for Nursing Practice, 361

13 Building an Evidence-Based Nursing Practice, 414

14 Outcomes Research, 466

Glossary, 500

Index, 515

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6th Edition

Understanding
Nursing Research
Building an Evidence-Based Practice

Susan K. Grove, PhD, RN, ANP-BC, GNP-BC
Professor Emerita
College of Nursing
The University of Texas at Arlington
Arlington, Texas;
Adult Nurse Practitioner
Family Practice
Grand Prairie, Texas

Jennifer R. Gray, PhD, RN, FAAN
George W. and Hazel M. Jay Professor, College of Nursing
Associate Dean, College of Nursing
The University of Texas at Arlington
Arlington, Texas

Nancy Burns, PhD, RN, FCN, FAAN
Professor Emerita
College of Nursing
The University of Texas at Arlington
Arlington, Texas;
Faith Community Nurse
St. Matthew Cumberland Presbyterian Church
Burleson, Texas

3251 Riverport Lane

St. Louis, Missouri 63043

UNDERSTANDING NURSING RESEARCH: BUILDING

AN EVIDENCE-BASED PRACTICE, EDITION SIX ISBN: 978-1-4557-7060-1

Copyright © 2015, 2011, 2007, 2003, 1999, 1995 by Saunders, an imprint of Elsevier Inc.

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