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NRS-490 Professional Capstone Project

NRS-490 Professional Capstone Project

NRS-490 Professional Capstone Project
NRS-490 Professional Capstone Project
NRS-490 Professional Capstone Project

Literature Review While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone change proposal project, the literature review enables students to map out and move into the active planning and development stages of the project. 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 Statement 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 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. You are required to submit this assignment to Lopes write. Please refer to the directions in the Student Success Center. NRS-490 Professional Capstone Project

The psychiatric units record very high rates of falls particularly among the geriatric population.Severe injuries and deaths are associated outcomes of falls which makes it a serious concern in the healthcare sector. It was projected that the United Statesfall-related expenses would approach $43.8 billion annually by 2020 thus necessitating the formulation of preventive measures by the federal law makers and healthcare facilities (Struble, Oswald &DiPersia, 2019). However, for the longest time, research carried over the years has focused on nursing homes, long-term care units and acute medical-surgical units thus leaving out the mental health units(Accardi& Chamberlain, 2019). This has resulted in the availability of limited evidence based information regarding prevention and management of falls and associated consequences and therefore, this paper seeks to develop a PICOT providing a framework for fall prevention in psychiatric health project.


The PICOT Statement

For psychiatric unit inpatients, does conducting hourly safety rounds compared to normal hospital routine without interventionshelp in reducing patient falls?

P (Population/ problem) Psychiatric unit inpatients/ falls
I (Intervention) Hourly Safety rounds
C (Comparison) No intervention
O (Outcome) Reduced falls
T (Time) Three months


The population of study will include the psychiatric patients prone to falls. This is because; this setting experiences many fall cases which are often unexplained. Falls cause injuries and deaths to all age groups and particularly elderly adults and therefore, the project will focus on the mental health inpatients in the geriatric units aged 65 years and above. With the changes in lifestyle and modernization, geriatrics experience difficulties in adjusting to old age which makes them prone to psychological disorders such as depression, Alzheimer’s and insomnia among others. Fall factors include generalized weakness, history of falls, disorientation or confusion, difficulty with walking or mobility, temperature deviation, and elimination problems (Jarrell, 2016). Most of these falls usually happen when these patients attempt getting out of bed, changing from a sitting to a standing position or even when walking to the bathroom.As such, considering the increased projected rates for this population, it is necessary to seek a preventive measure for falls among these persons. NRS-490 Professional Capstone Project

Evidence-Based Nursing Intervention

The project seeks to determine the impact of hourly safety rounds intervention by nurses in the inpatient psychiatric units on the rate of fall prevention. The integration of hourly protocols into the nursing practice present an effective evidence-based intervention essential in decreasing the rate f falls in the psychiatric wards. The safety rounds address pain whereby the assessment of pin level and management is conducted. In addition, personal needs are addressed which include hydration, help in attending the toilet and bathroom, empty urinals and nutrition as well as positioning that places the patient in comfortable state for skin integrity maintenance(Brown, 2017).Consequently, the rounds focus on placement which ensures the essential patients’ needs are available within their rich and lastly, prevention of falls by engaging the patient and family on safety measures such as putting on a call light when in need of getting off the bed(Gavaller, Gavaller& Oh, 2019). Literature reviews indicate that hourly safety rounds are significant in reducing documentation, increasing efficiency and improving safety, quality as well as the patient’soutcomes(Rone, 2018).


There is no comparison intervention for this project. Instead, some patients will receive the usual clinical routines to be able to differentiate the outcomes of the treated patients and those acting as the control.


The project intends to record reduced number of falls within the time of study. This is because; using hourly rounding within the inpatient’s psychiatry unit of a healthcare agency is associated with significant improvements in reducing the risk of falls. A significant hourly rounding result is the improved patient/staff contentment and reduced negative patient events (Linehan&Linehan, 2018). Besides, hourly rounding acts as an approach to keep patients free from any harm through the reduction of pressure ulcers and the risk of falls. It will also enable nurses to spend more time with patients in the psychiatry unit, thereby reducing falls by attending to the immediate care needs of the patients(Stoeckle, Iseler, Havey&Aebersold, 2019). Additionally, hourly rounding will allow effective usage of call light, the numb of falls, and patient satisfaction. NRS-490 Professional Capstone Project


The psychiatric inpatients will receive hourly safety rounds within aperiod of three months. This will be the amount of time allocated for the project and it is considered sufficient enough to draw generalizable conclusions about the study.


Accardi, S. R., & Chamberlain, C. (2019).Individualized Fall Prevention Care Plan to Decrease Fall Rates in an Adult Inpatient Psychiatric Unit. Poster presented at Nursing Boot Camp at Providence St. Vincent Medical Center in Portland, OR.

Brown, A. M. (2017). Reducing falls after electroconvulsive therapy: a quality improvement project. Journal of psychosocial nursing and mental health services, 55(7), 20-29.

Gavaller, M., Gavaller, M., & Oh, H. (2019).Impact of Bed Alarm Removal and Implementation of Hourly Rounding to Reduce Falls. Journal of the American Medical Directors Association, 20(3), B19.

Jarrell, J. L. (2016). Systematic Appraisal of the Literature on the Effectiveness of Fall Prevention Interventions in Acute Care Settings.

Linehan, J., &Linehan, J. (2018). Fall Prevention in Long Term Care Using Purposeful Hourly Rounding. Journal of the American Medical Directors Association, 19(3), B17.

Rone, C. (2018). It’s Peak Time: Prevent Falls with Hourly Rounding. In ONCOLOGY NURSING FORUM (Vol. 45, No. 2). 125 ENTERPRISE DR, PITTSBURGH, PA 15275 USA: ONCOLOGY NURSING SOC.

Stoeckle, A., Iseler, J. I., Havey, R., &Aebersold, C. (2019). Catching quality before it falls: preventing falls and injuries in the adult emergency department. Journal of emergency nursing, 45(3), 257-264.

Struble-Fitzsimmons, D., Oswald, A., &DiPersia, E. (2019). Patient Location and Mobility Factors Associated with Falls on an Inpatient Geriatric Psychiatry Unit. Activities, Adaptation & Aging, 43(4), 276-283.





NRS-490 Professional Capstone Project

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