Safety is a consistent priority in all aspects and areas of nursing. Fall prevention is especially important in keeping our patients safe from harm while they are under our care. Falls are preventable hospital acquired injuries that leave room for process improvement. In order to provide optimal care, I have developed a searchable clinical question related to fall prevention to investigate in a database. Is control of environmental factors more effective than safety education at decreasing the incidence of falls in high fall-risk patients? Identifying high risk patients is a nursing responsibility (Shuey & Balch, 2014) and creating an individualized safety plan is paramount for fall prevention.
The PICO (T) format was used to develop the above quantitative clinical question. These components were used to cultivate a relevant search for articles that address the topic directly. Limiting the search scope to these key terms yielded a variety of sources pertinent to the clinical question. The target population ("P") being addressed in the clinical question is high fall-risk patients. We identify patients to be considered high risk based on several factors ranging from immobility to confusion. The intervention ("I") indicated is control of environmental factors.
Environment is addressed in assessment of the patient's space or room. For example, nursing staff is to make sure there are clear pathways for ambulation and that beds are locked and in low position. The comparison ("C"), or alternative to the intervention, is safety education. Providing education to our patients regarding room safety and orientation is imperative to fall prevention and could also include a fall or safety agreement. The outcome ("O") is the defined goal of the clinical question and is to decrease the incidence of falls in high fall-risk patients. The outcome is to be achieved through the implementation of the intervention, the comparison, or both. There is no distinct time ("T") that is appropriate for this clinical question.
Overall, using an integral approach to enhance direct patient care is the key to safety. Applying the PICO (T) format to the database search for articles provided optimum sensitivity and specificity. This clinical inquiry incorporates all the aspects of a searchable question with a focus on treatment and reduction of risk factors. In this case, a combination of the intervention of a controlled patient environment and the comparison of safety education would likely be the most effective to produce better patient outcomes. Utilizing many safety strategies will facilitate and promote patient safety and fall prevention.