CLC - EBP Develop Clinical Guideline and Implementation Plan

In a 750-1,000 word paper, complete the protocol and write the plan to pilot the change in practice.
The clinical guidelines should include the problem statement, EBP question, literature review, research synthesis, the clinical protocol, and the implementation plan. Identify specific, realistic patient outcomes that will be used for evaluating the clinical guidelines.
The implementation plan for the protocol should include a timeline with criteria for evaluating the outcomes. Barriers/Obstacles or drivers for change should be identified and addressed.
Refer to the "CLC Assignment: Evidence-Based Project (EBP) Student Guide" for additional guidance.
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 Turnitin. Please refer to the directions in the Student Success Center.
Identification of Clinical Question
Foreground question: In elderly patients, are exercise programs more effective than hip protectors in the prevention of fall-related injuries in healthcare facilities?
Elderly people are more likely to fall than younger people because they suffer from chronic health issues that cause loss of balance, and are also affected by poor sight and weakening of the muscles. Further, such falls are likely to be fatal as they may result in bone fractures. Fall-related injuries have been deemed as the most common cause of fatal and non-fatal injuries among elderly people (Gill, et al., 2016). Thus, it is important to establish evidence-based prevention strategies that are effective. Fall-related injuries among elderly people have led to admission in hospitals due to the seriousness of the injuries, and in some instances, they have resulted in the admission of the patient to nursing homes for longer periods (Gill, et al., 2016). The elderly are also likely to become disabled following an injury from a fatal fall which then reduces their quality of life (Goodwin, et al., 2014). Apart from the physical pain and adverse health outcomes on the part of the patient, there are other elements of fall-related injuries that put pressure on the healthcare system. As noted by Goodwin, et al. (2014), each year, the UK health system spends approximately £1.7 billion on fall-related injuries. In the U.S.A. the treatment of fall-related injuries costs around $28.2 billion each year, and most of these costs are incurred in the treatment of falls that result in admission. Nurses are responsible for ensuring patient safety and improving the patients’ outcomes. Fall-related injuries increase the number of patients under a nurse’s care because as noted by The Joint Commission (2015), it prolongs the stay in the hospital for approximately 6 more days. As such, it also increases the number of hours a nurse has to put in taking care of the patient, which could have been avoided or reduced. Prevention of fall-related injuries will reduce patient overload on nurses, enabling them to take care of other patients.
As noted earlier, falls among the elderly are common due to the weakening of their muscles and loss of balance. As such, preventive measures that can strengthen the muscles are deemed appropriate. Luk, Chan, and Chan (2015) indicate that exercise is one of the best evidence-based fall preventative strategies. This is because they strengthen the muscles and improve balance. For this to be effective, the exercise should be appropriate, of sufficient intensity and regular (Luk, Chan, & Chan, 2015). Using exercise can be approached with skepticism because of the fear of causing muscle soreness to patients. However, Tricco, et al. (2017), revealed that there is no significant association between exercise and risk of increased muscle soreness. This thus points out to the safety of using exercise in the prevention of elderly falls. Further, there is evidence that exercise alone results in a reduced risk of fall, as compared to the other strategies (Tricco, et al., 2017).
Other studies, such as the one conducted by Uusi-Rasi, et al. (2015), also indicate that exercise is the most effective and sustainable approach to prevent falls and fall-related injuries. Older people, whether in hospitals or nursing homes can benefit from exercise because it treats the underlying causes of elderly falls by improving mobility, balance and strengthening muscles (Uusi-Rasi, et al., 2015), unlike other preventative measures such as hip protectors which only reduce the severity of the fall-related injuries.
References
Gill, T. M., Pahor, M., Guralnik, J. M., McDermott, M. M., King, A. C., Buford, T. W., et al. (2016). Effect of Structured Physical Activity on pRevention of Serious Fall Injuries in Adults Aged 70-89: Randomized Clinical Trial (LIFE Study). BMJ, 1-8.
Goodwin, V. A., Abbott, R. A., Whear, R., Bethel, A., Ukoumunne, O. C., Thompson-Coon, J., et al. (2014). Multiple Component Interventions for Preventing Falls and Fall-realted Injuries among Older People: Systematic Review and Meta-analysis. BMC Geriatrics, 14(1), 1-8.
Luk, J. K., Chan, T., & Chan, D. K. (2015). Falls Prevention in the Elderly: Translating Evidence into Practice. Hong Kong Medical Journal, 1-7.
The Joint Commission. (2015). Preventing Falls and Fall-realted Injuries in Health Care Facilities. Sentinel Event Alert, 55, 1-5.
Tricco, A. C., Thomas, S. M., i Veroniki, A. A., Hamid, J. S., Cogo, E., Strifler, L., et al. (2017). Comaprison of Interventions for Preventing Falls in Older Adults: A Systematic Review and Meta-analysis. JAMA, 318(17), 1687-1699.
Uusi-Rasi, K., Patil, R., Karinkanta, S., Kannus, P., Tokola, K., Lamberg-Allardt, C., et al. (2015). Exercise and Vitamin D in Fall Prevention among Older Women: A Randomized Clinical Trial. JAMA Inernal Medicine, 175(5), 703-711.
Earlier comments from instructor noted below:
You wroteYou wrote a PICO question. That works with research studies because you can do a comparison experiment. Looking at literature for this will not give you that infomration. So, you need to choose one of the interventions and do a PIO question (p. 33 in your text). So it might look like: In elderly patients, are exercise programs effective in the prevention of fall-related injuries in healthcare facilities? Also, please note that in the 6th edition of the APA manual, the DOI or a url is required for each journal reference. I have posted GCU’s APA style guide in the main forum to help. Please let me know if you have any questions. Thanks. a PICO question. That works with research studies because you can do a cmparison experiment. Looking at literature for this will not give you that infomration. So, you need to choose one of the interventions and do a PIO question (p. 33 in your text). So it might look like: In elderly patients, are exercise programs effective in the prevention of fall-related injuries in healthcare facilities? Also, please note that in the 6th edition of the APA manual, the DOI or a url is required for each journal reference. I have posted GCU’s APA style guide in the main forum to help. Please let me know if you have any questions. Thanks.
In your week 7 paper, you will need to, “In a 750-1,000 word paper, complete the protocol and write the plan to pilot the change in practice.
The clinical guidelines should include the problem statement, EBP question, literature review, research synthesis, the clinical protocol, and the implementation plan. Identify specific, realistic patient outcomes that will be used for evaluating the clinical guidelines.
The implementation plan for the protocol should include a timeline with criteria for evaluating the outcomes. Barriers/Obstacles or drivers for change should be identified and addressed.
Right now, I do not see that you have the information to complete that plan. You will need to write a PIO question in which you select to EBP and also clarify the health care setting. After that, you will need to find sufficient evidence that the EBP works. Then the rest of the assignment information will need to be developed. I would suggest that your group talk and select the EBP and find more articles to provide support. Please let me know if you have any questions.