Advanced Levels of Clinical Inquiry and Systematic Reviews of Fall Prevention with Video Surveillance

PICOT QUESTION – In the acute care setting for patients 18 years of age and older, how does the use of virtual sitters versus 1 to 1 bedside sitters impact patient falls and financial costs?

Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to the research question. If there are no systematic review level articles or meta-analysis on the topic, then use the highest level of evidence peer reviewed article.
Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

BUY A PLAGIARISM-FREE PAPER HERE

Advanced Levels of Clinical Inquiry and Systematic Reviews of Fall Prevention with Video Surveillance

Guirguis-Blake, J. M., Michael, Y. L., Perdue, L. A., Coppola, E. L., & Beil, T. L. (2018). Interventions to prevent falls in older adults: updated evidence report and systematic review for the US Preventive Services Task Force. Jama, 319(16), 1705-1716.

Guirguis-Blake et al (2018) conducted a systematic review study on the interventions used and effective in preventing falls in the geriatric population. The systematic review included the critical review of randomized placebo-controlled trials and randomized controlled trials on the study topic. The retrieved articles were independently reviewed by two researchers against the quality criteria and the set inclusion criteria.

Systematic reviews are assigned the highest level of evidence because they provide a summary of numerous studies. The advantages of systematic reviews include the elimination of bias. This is because independent reviewers are involved in the review of the included studies as well as in the critical analysis of the quality of the included studies. For example, in this study, two independent reviewers critically reviewed the quality and relevance of all the included studies against the set inclusion criteria. This indicates that systematic reviews are essential and useful in providing an overview and summary of the existing evidence about a particular research topic. Moreover, in systematic reviews, a detailed comprehensive search strategy is employed. For example, in this study, studies were searched from MEDLINE, Cochrane Library, Cumulative Index for Nursing and Allied Health Literature, and PubMed. These are reliable databases that provide high-quality and peer-reviewed studies.

Khalifa, M. (2019). Improving Patient Safety by Reducing Falls in Hospitals Among the Elderly: A Review of Successful Strategies. In ICIMTH (pp. 340-343).

Khalifa et al (2019) conducted a systematic review to find out the strategies effective in reducing falls among the geriatric population. One advantage of a systematic review is that a comprehensive search strategy and a detailed and specific inclusion criterion avoids bias and increases the reliability and validity of the findings. For example, in this study, the methodology included a comprehensive search of the relevant studies from Google Scholar, Medline, CINAHL, and EMBASE. In this study, the use of video-based materials was found to be very effective in ensuring patient safety when compared to the use of written materials to educate patients about falls. Systematic reviews form the highest form of evidence and this research method is useful in identifying and selecting studies to generate accurate and reliable findings. Additionally, a review provides a summary of findings from numerous studies and this is easier to read, synthesize, and understand the information. For example, in this study, evidence from 34 studies was synthesized.

Cournan, M., Fusco‐Gessick, B., & Wright, L. (2016). Improving patient safety through video monitoring. Rehabilitation Nursing, 43(2), 111-115.

Cournan, Fusco‐Gessick & Wright (2016) conducted a sequential cohort study to investigate the impact of video monitoring on patient safety. A video monitoring system allows patients at the risk of falls to be monitored remotely. Findings indicated that the video monitoring system reduced the rate of falls in the hospital. This study is peer-reviewed and it is a sequential cohort belongs to Level IV. Level IV studies include evidence from well-designed cohort studies and case-control studies.

Because of the limited sample sizes, several studies especially comparative studies are not adequately powered. Therefore, a single study may not detect the actual variation and as a result provide a false negative finding, especially if the difference is small. Moreover, studies that use larger sample sizes may not be logistically or economically viable. Additionally, due to the large amount of data that is published every year, it might be impossible to track all pertinent studies to identify the answer to a specific clinical problem. Therefore, a systematic review is appropriate to provide a summary of the available evidence from numerous research studies and ensure more accurate findings and conclusions for clinical practice.

Davis, J., Kutash, M., & Whyte IV, J. (2017). A comparative study of patient sitters with video monitoring versus in-room sitters. Journal of Nursing Education and Practice, 7(3), 137-142.

Davis et al (2017) conducted a quasi-experimental study to investigate the efficacy of sitter with video-monitoring when compared to in-room sitters. The study aimed to identify the incidence of patient falls and harm utilizing video monitoring and in-room sitters, and the allied costs. Findings indicated that video monitoring was more cost-effective and also effective in preventing falls.

This study is a quasi-experimental study and quasi-experimental research studies are in level III of the evidence hierarchy. The study is also peer-reviewed. However, a systematic review study would have provided a summary of studies comparing the efficacy and cost-effectiveness of in-room sitters and video-monitoring in reducing the rate of falls.

References

Cournan, M., Fusco‐Gessick, B., & Wright, L. (2016). Improving patient safety through video monitoring. Rehabilitation Nursing, 43(2), 111-115.

Davis, J., Kutash, M., & Whyte IV, J. (2017). A comparative study of patient sitters with video monitoring versus in-room sitters. Journal of Nursing Education and Practice, 7(3), 137-142.

Khalifa, M. (2019). Improving Patient Safety by Reducing Falls in Hospitals Among the Elderly: A Review of Successful Strategies. In ICIMTH (pp. 340-343).