Hi Dr Kyzar and class Whether the author identified the scope of evidence synthesis             The scope of the evidence synthesis is focused on the issue of patient falls with injuries and the challenges related to the prevention of falls within the acute cares settings. The author has identified this scope by drawing pieces of evidence from various authors. The evidence drawn from the previous studies indicates that the issue of patient falls is a major adverse event that interferes with the quality of healthcare services that are being provided to the patients within the acute care settings for example nursing homes and healthcare facilities. The study reveals that the detrimental effects caused by the issues of patients' falls are associated with serious bruises, trauma, fractures, and death of the patients when it is not prevented at the right time (Araujo, et al., 2017).             The evidence also supports the focus of the author by revealing that the issue of falls is a common problem that is being experienced by elderly patients. It shows that one in every three individuals more than 65 years old suffer from at least one fall every year. This is associated with either alone of combined factors such as environmental factors, social factors, psychological factors. Therefore, the author has managed to gather the literature that helps in addressing the research area that is to say the issue of patient falls. The author has managed to synthesize the literature by comparing the literature studies referenced in this work. The author has managed to assess and interpret to help in concluding on the issue of patients' falls and how it is becoming an issue within the acute care and to the healthcare providers (Araujo, et al., 2017). Whether stronger paraphrased sentences are included to help in supporting the contemporary sources of research evidence               Through providing the description, summary, analysis, and identification of the key concepts; there is successful paraphrasing of the sentences to help in supporting the sources of the research evidence. The evidence from one of the research evidence used i.e. (Gygax Spicer, 2017) shows the issue of falls to be a common problem amongst elderly individuals due to the factors that are either combined or occurring singularly. These factors include social, environmental, and psychological factors. This evidence is supported by the paraphrased sentence which states that the etiology of falls among their elderly patients is as a result of attempting to get out of the bed without any form of assistance from the team of healthcare providers such as nurses. The issue is further increased by other causative factors such as diseases, impulsiveness, urgency, medications, and lack of knowledge about the hospital environment. Another issue that is paraphrased to support the evidence from the research is the turnover problem among healthcare providers. Due to the inadequate number of healthc.

1. Hi Dr Kyzar and class
Whether the author identified the scope of evidence synthesis
The scope of the evidence synthesis is focused on the
issue of patient falls with injuries and the challenges related to
the prevention of falls within the acute cares settings. The
author has identified this scope by drawing pieces of evidence
from various authors. The evidence drawn from the previous
studies indicates that the issue of patient falls is a major
adverse event that interferes with the quality of healthcare
services that are being provided to the patients within the acute
care settings for example nursing homes and healthcare
facilities. The study reveals that the detrimental effects caused
by the issues of patients' falls are associated with serious
bruises, trauma, fractures, and death of the patients when it is
not prevented at the right time (Araujo, et al., 2017).
The evidence also supports the focus of the author by
revealing that the issue of falls is a common problem that is
being experienced by elderly patients. It shows that one in every
three individuals more than 65 years old suffer from at least one
fall every year. This is associated with either alone of combined
factors such as environmental factors, social factors,
psychological factors. Therefore, the author has managed to
gather the literature that helps in addressing the research area
that is to say the issue of patient falls. The author has managed
to synthesize the literature by comparing the literature studies
referenced in this work. The author has managed to assess and
interpret to help in concluding on the issue of patients' falls and
how it is becoming an issue within the acute care and to the
healthcare providers (Araujo, et al., 2017).
Whether stronger paraphrased sentences are included to help in
supporting the contemporary sources of research evidence

2. Through providing the description, summary, analysis,
and identification of the key concepts; there is successful
paraphrasing of the sentences to help in supporting the sources
of the research evidence. The evidence from one of the research
evidence used i.e. (Gygax Spicer, 2017) shows the issue of falls
to be a common problem amongst elderly individuals due to the
factors that are either combined or occurring singularly. These
factors include social, environmental, and psychological factors.
This evidence is supported by the paraphrased sentence which
states that the etiology of falls among their elderly patients is as
a result of attempting to get out of the bed without any form of
assistance from the team of healthcare providers such as nurses.
The issue is further increased by other causative factors such as
diseases, impulsiveness, urgency, medications, and lack of
knowledge about the hospital environment. Another issue that is
paraphrased to support the evidence from the research is the
turnover problem among healthcare providers. Due to the
inadequate number of healthcare providers such as nurses to
spend more time with the patients, these elderly remains to be
highly exposed to the risk of falls as a result of the low ratio of
nurse to the patient (Gygax, 2017).
Whether the facts presented are related to the practice problem
that has been presented in an objective way
The facts presented in the article through research
evidence and conclusion from the research findings have been
done objectively and they are based on the issue of patient falls
and injuries and fall prevention. One of these facts is that the
issue of patient falls is a common problem within acute care
facilities such as nursing homes and hospitals. They are linked
to some of the preventable factors related to the social,
environmental, and psychological factors. Due to the reduction
in the ability to perform most of the ADLs, elderly patients are
considered to be high-risk individuals who require help from the

3. nurses to overcome the issue of falls which increases the risks
of preventable injuries and deaths. These patients also
experience the side effects of the medications, illness,
impulsiveness, and urgency thus exposing them to a high risk of
falls when effective interventions are not developed (Araujo, et
al., 2017).
The other key fact linked to the issue of fall prevention
is the lack of adequate nurses to help patients with their needs
such as pottying and movement within the hospital. Due to the
lack of knowledge about the hospital environment as well as
lack of adequate to respond to their needs immediately, elderly
patients remain highly exposed to severe bruises, fractures,
traumas, and preventable deaths (Araujo, et al., 2017).
Whether the author uses sources to support the ideas and claims
The argument presented by the author is supported by
the evidence from past studies. According to the argument from
the author, the issue of falls among patients occurs as a result of
their attempts to get out of bed without any form of assistance
from the nurses. The author also argues that patients' falls is
also associated with the urgency, illness, medication being used
by the patients, impulsiveness, and unfamiliarity with the
hospital environment in addition to the increase in the turnover
of the nurse staffing which reduces the number of nurses in the
hospitals.
These arguments are supported by the research evidence
used by the author. According to Gygax Spicer (2017), one to
three persons of ages 65 years and above do suffer from at least
one fall every year as a result of multiple factors that are linked
to social, environmental, and psychological factors. The issue of
illness, impulsiveness, urgency, and medication as presented by
the author is the social and psychological factors that are
demonstrated in the research evidence. The issue of a low

4. number of patients is an environmental factor within the
hospital facility. This increases the level of exposure of these
patients to the risk of falls (Gygax, 2017). According to the
author, patients always attempt to get out of their bed without
any assistance from the nurses. Due to the lack of knowledge
about the environment of the hospitals, the majority of them
fall. De Medeiros Araujo et al (2015) shows that such falls
expose them to mild and severe bruises, fractures, traumas, and
even deaths. The few numbers of nurses in the facility imply
that there would be no nurses left to keep an eye on other
patients who might require help with pottying and bathing (de
Medeiros Araujo, et al., 2017).
Whether this exemplar is a true synthesis of the evidence
The exemplar presented is a true synthesis of the
evidence concerning the issue of patient falls and the complex
nature of preventing such falls. Even though the presentation is
majorly based on the arguments based on the research evidence,
the information presented is a true reflection of what is
happening in acute care settings. Even though efforts have been
made to help in addressing the issue of patient falls, the
evidence synthesis further confirms that addressing this issue is
still complicated as a result of the high turnover that leads to
the low number of nurses to care for the growing number of
patients who are seeking services for their chronic conditions.
The low number of nursing staff makes it impossible to
implement the nursing hourly rounds and this complicates the
interventions of efforts being made to ensure that there is the
successful process of implementing the nursing hourly rounds
(Araujo, et al., 2017).
The issue of patient falls is also associated with the
problems caused by the medication and the psychological issues
of the patients. The reduction in physical strength and mental
well-being results in the reduction of the ability of the patients

5. to perform their ADLs such as bathing. In acute care, these
patients require help from the patients with the roles such as
bathing and pottying. Due to the lack of adequate nurses, it
makes it hard for these patients to have their needs rendered at
the right time. Therefore, they are forced to get out of bed with
no form of help from the nurses. Due to their reduced physical
and mental ability as well as lack of knowledge about the
hospital environment, they find themselves falling on the
ground thus exposing them to mild to severe bruises, fractures,
trauma, and death. Therefore, the effective process of
addressing the issue of patients' falls requires the process of
dealing with the complications within the facility at first for
example addressing the issue of lower nurse-patient ratios and
improvement in the hospital environment by increasing the
number of caregivers within the wards while nurses are busy
caring for other patients (Araujo, et al., 2017).
References
Araujo, J. N., Fernandes, A. P., Moura, L. A., Santos, M. M.,
Ferreira Junior, M. A., & Vitor, A. F. (2017). Validation of
nursing outcome content Fall prevention behavior in a hospital
environment. http://www.repositorio.ufc.br/handle/riufc/23831
de Medeiros Araujo, C. X., de Lima Silva, V., Guerra, G. C.,
Ferreira, A. H., de Araujo Barbosa, S. J., & de Araujo Junior,
A. A. (2017). Quality of life, integrative community therapy,
family support, and satisfaction with health services among
elderly adults with and without symptoms of depression.
Psychiatric Quarterly, 88
(2), 359-369. https://doi.org/10.1007/s11126-016-9453-z
Gygax, S. J. (2017). The Got-A-Minute Campaign to Reduce
Patient Falls with Injury in an Acute Care Setting.
MedSurg Nursing, 26
(5).