Towards a standardised methodology for measuring the burden of disability due to injury
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This document discusses establishing standardized methods for measuring disability due to injuries. It recommends using Disability Adjusted Life Years (DALYs) as a measure that integrates different health outcomes, allowing comparison between diseases. Calculating DALYs requires data on injury incidence, age distribution, disability weights, and duration. Key questions addressed are which injury cases to include, how to distinguish cases by diagnosis, and how to link diagnoses to disability information. The document reviews options and recommends using the EUROCOST injury classification system and deriving disability weights through panel studies.
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Running head: Qualitative Research Critique and Ethical Considerations 1
2
Qualitative Research Critique and Ethical Considerations
Salice Acha Njei
Grand Canyon University: (NRS-428VN)
06/16/2020
PICOT Question:
For hospitalized patients age 65 and older (P), does the use of bed alarms (I), compared to current practice (C), reduce the number of fall incidents (O), within 4 weeks (T)?
Majkusová et al. (2016) describes a fall as an event that results in an individual coming to rest inadvertently on the ground, floor or other lower level. Older people are at a greater risk of fall and this has significant consequences to their quality of life and that of their families. With the population of people who are 65 years and above set to more than double in the next decade, it is undoubtedly important that risk factors are established and an effective prevention program established to mitigate these falls. This way, hospitals are implementing bed alarms to improve patient safety and quality of care delivery. Therefore, this discussion will critique these two qualitative studies that support the proposed evidence-based practice initiative to support the central question in this research paper which is “can the use of alarm sensors or bed alarms reduce fall incidents with the elderly in a hospital setting?”.
Qualitative Studies
According to Majkusová et al. (2016) qualitative study is a research method conducted in natural settings, and the used data are words or text, rather than numerical, in order to describe the experiences that were being studied. There are a variety of methods of data collection in qualitative research, including observations, textual or visual analysis (example from books or videos) and interviews (individual or group).The first qualitative study is Enema, D. M., Skinner, A. M., Nailon, R., Conley, D., High, R., & Jones, K. J. (2019). Patient and system factors associated with unassisted and injurious falls in hospitals: an observational study. BMC Geriatrics, 19(1), 1. Retrieved from:
https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/detail/detail?vid=0&sid=bedb2bb0-ec00-4d86-abcf 092c57247ca2%40sessionmgr4008&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=140312571&db=edb. The second one is Majkusová, K., Jarošová, D., Zeleníková, R., & Kozáková, R. (2016). Assessing the methodological quality of clinical guidelines for preventing falls of patients. Central European Journal of Nursing & Midwifery, 7(4), 549. Retrieved from:
https://eds-b-ebscohost-com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=0&sid=da9cb59c-18bc-4aec-899b-72423a431e61%40pdc-v-sessmgr02. These two qualitative studies support the fact that implementing bed alarms in hospital settings helps to reduce the number of falls incidents with the elderly population.
Background of Study
Older people are more susceptible to falls than young people because of a few factors. These factors may include, how.
Presentatie svin deneckere_itineraevent
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Treinamento
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Key findings from the IDB data collected from 3 hospitals in Cork, Ireland include:
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Assessment Description
Reflecting on the "IHI Module QI 202: Addressing Small Problems to Build Safer, More Reliable Systems," describe how your direct practice improvement project achieves clinical improvement. How will you achieve widespread change? How would the widespread change of your DPI Project be affected if it were implemented in a country with universal health care. Describe how the health outcome would be impacted. Provide supporting evidence.
Shabnampreet Kaur
The IHI module QI 202: Addressing Small Problems to Build Safer, More Reliable Systems, reflects on the presence of small problems in healthcare systems and how to overcome these small problems to build safer systems. Steve Spear used various examples to make the readers understand the concept of small loopholes and workarounds which distract the employees resulting in mistakes and sometimes these mistakes become catastrophes(Institute for Healthcare Improvement, 2022b). Also, he suggested ways to address them and make healthcare safer. My DPI project which is fall prevention among older adults achieves clinical improvement by building stronger techniques for addressing the reasons and suggesting ways to improve strength, gait, and balance using tai chi as the intervention. Currently, at the practice site, there is only a shift-to-shift report as the standard criteria for fall reporting. Many times people forget to bring to the provider's notice that they experience a fall in the past 3 months. And sometimes if falls are reported, the shift duty nurses forget to enter them into the EHR system. Also, there is currently no special protocol for fall screening. Screening and assessment can help providers know about the population prone to falling and then they can work towards achieving the aim of fall prevention by devising various patient-centered interventions, My DPI project will streamline the process of screening all the older adults above the age of 65 years with CDC STEADI Stay Independent questionnaire (Centers for Disease Control and Prevention.,2020). Those screened at risk will undergo assessment for fall risk factors using a Timed up and go, 30-second chair rise and balance test, with identification of medicines as per Beers criteria, measurement of orthostatic blood pressure, and asking about potential home hazards. Those having poor balance gait and strength will be enrolled in a 12-week tai chi exercise program as the intervention. In order to achieve widespread change, teamwork and collaboration are needed at the levels of the project. Potential sources of mistakes will be addressed in the first place, the commonest of all being linking the fall risk assessment to the patient's e-chart. If my DPI project were implemented in a country with universal healthcare, the widespread change of the project will be affected in multiple ways. Universal healthcare coverage means all people have full access to hea.
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Lucia PASTORE CELENTANO, MD, MSc
Head of the Vaccine Preventable Diseases Programme, ECDC
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European Health Forum Gastein, 05 October 2017Collaborative 2016-british journal-of_surgery
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Contents lists available at ScienceDirectInternational Jou
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International Journal of Orthopaedic and Trauma Nursing
journal homepage: www.elsevier.com/locate/ijotn
Prevention of heel pressure ulcers among adult patients in orthopaedic
wards: an evidence-based implementation project
Siew Yi Koha, Hui Ling Yeoa, Mien Li Gohb,∗
aUniversity of Orthopaedic Cluster, National University Hospital, Singapore
b Evidence Based Nursing Unit, National University Hospital, Singapore
A B S T R A C T
Background: Immobility and prolonged bed rest often lead to heel pressure ulcers in patients. A point prevalence audit undertaken in the orthopaedic wards of a
Singapore tertiary hospital reported that 6 out of 30 patients who were audited had mild to blanching redness on their heels.
Aims: The evidence-based project sought to achieve 80% compliance from nurses to perform heel off-loading practice and a 50% reduction in the occurrence of heel
pressure ulcers.
Methods: The project, lasting two years, was undertaken in two orthopaedic wards and utilized a pre- and post-implementation audit strategy using the Joanna Briggs
Institute on-line 'Practical Application of Clinical Evidence System' and 'Getting Research into Practice' programs. Implementation occurred in four phases and
involved a sample consisting of 30 adult patients.
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heel off-loading techniques in the subsequent four follow-up audits. Meanwhile, the compliance with documentation increased from 63.3% to 86.7%. The project
resulted in more than 50% reduction in stage one heel pressure ulcers.
Conclusion: The implementation of heel off-loading techniques significantly reduced the incidences of heel pressure ulcers in orthopaedic wards.
Background
Pressure ulcers are a common and perpetual problem in healthcare
settings worldwide (Corbett et al., 2017). Pressure ulcers (PUs), also
known as pressure injury or bed sores, are areas of necrotic soft tissue,
that usually occur over bony prominences (Ministry of Health [MOH]
Nursing Clinical Practice Guidelines, 2001; Sussman and Bates-Jensen,
2007; Smeltzer et al., 2010). They usually develop when skin is sub-
jected to shear, friction and prolonged unrelieved pressure. Many areas
in the human anatomy are susceptible to PUs, for instance occiput,
sacrum, elbow and heel (Smeltzer et al., 2010).
There are six classifications of PUs (National Pressure Ulcer
Advisory Panel, European Pressure Ulcer Advisory Panel, & Pan
Pacific Pressure Injury Alliance, 2014). Stage one PU presents as
non-blanching discoloration of intact skin, often in red, blue or
purplish hues. Stage two PUs involve partial thickness loss of
dermis with a shallow wound or intact blister. An ulcer progresses
to stage three when there is full thickness tissue loss, accompanied
by undermining or tunneling. Full thickness tissue loss with ex-
posed bone ...
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