{"id":95826,"date":"2018-02-08T21:17:09","date_gmt":"2018-02-08T21:17:09","guid":{"rendered":"https:\/\/essay-pool.com\/evidencedbasedarticlesthatpromotepatientsafety\/"},"modified":"2017-10-13T09:06:26","modified_gmt":"2017-10-13T09:06:26","slug":"evidencedbasedarticlesthatpromotepatientsafety","status":"publish","type":"post","link":"https:\/\/www.benedictsol.com\/blogs\/evidencedbasedarticlesthatpromotepatientsafety\/","title":{"rendered":"Evidenced?based?Articles?that?promote?patient?safety"},"content":{"rendered":"<p>\nDescription<br \/>\nFor this assignment you will:<br \/>\n1. review the 2 current and trustworthy\/scholarly research articles on a relevant patient safety topic (you are not<br \/>\nto use articles\/readings reviews that you ve obtained from another student   this exercise is to help you develop<br \/>\nyour skills in research) ARTICLES ARE ALREADY ATTACHED HERE. CHECK THE EMAIL OR<br \/>\nATTACHEMENT<br \/>\n2. For each article:<br \/>\na. Read the Abstract, Introduction, Discussion\/Results<br \/>\nb. Determine if this is an article that is of interest to you and offers information\/evidence that will<br \/>\ninform\/improve patients safety<br \/>\nc. For the articles you deem appropriate   as above, complete the following steps. <br \/>\n3. Provide a summary (in your own words) of the information in the   abstract, introduction, discussion\/results.<br \/>\nCreate a heading for each of the 3 areas, so that you instructor can clearly identify your summary. <br \/>\n4. In the summary of the abstract, identify if the article is qualitative or quantitative research. <br \/>\n5. Create a heading called  implications  and identify how this information can potentially enhance patient<br \/>\nsafety.<br \/>\n6. Create a heading called  Personal Reflection  and identify how YOU can incorporate or champion the<br \/>\nadoption of this information in your practice or care area<br \/>\n7. Review the attached rubric for a detailed breakdown on the assignment and expectations<br \/>\n8. The paper must:<br \/>\na. Utilize the APA guidelines<br \/>\nb. The paper MUST be checked for grammar and spelling prior to submitting   accurate, legible and well written<br \/>\ncommunication is very important to patient safety<br \/>\nc. The paper must include a cover page and reference list<br \/>\nd. The paper must include an introduction and a conclusion<br \/>\ne. The body of the paper must be 5   6 pages double spaced<br \/>\nf. The 2 articles that you review MUST be included in a reference <br \/>\nREMINDERS: just focus on making the 5 pages for the body. I will be the one to make the cover page ans<br \/>\nreference page. I will only pay for the 5 pages for the body of essay<\/p>\n<p>September-October 2016   Vol. 25\/No. 5 329<br \/>\nKay Klymko, PhD, ARNP, FNP-BC, is Nurse Practitioner, Florida Health Care Plans, Daytona<br \/>\nBeach, FL.<br \/>\nLuAnn Etcher, PhD, GNP-BC, is Associate Professor, Spring Arbor University School of<br \/>\nHuman Services, Arbor, MI.<br \/>\nJoan Munchiando, BSN, RN-BC, CRRN, CMSRN, NE-BC, CDP, is Director of Specialty<br \/>\nPrograms, Nursing Administration, NICHE Co-Coordinator, Beaumont Health System, Royal<br \/>\nOak, MI.<br \/>\nMary Royse, MSN, RN, CMSRN, CDP, is Clinical Nurse Specialist for Medical &amp; Acute Care of<br \/>\nthe Elderly Unit, Beaumont Health System, Royal Oak, MI.<br \/>\nAcknowledgments: The authors thank Therese Swann, RN, and Kelly Marie Ellsworth, who<br \/>\nprovided assistance with literature searches during their graduate programs at Wayne State<br \/>\nUniversity (Detroit, MI).<br \/>\nVideo Monitoring: A Room with a<br \/>\nView, or a Window to Challenges in<br \/>\nFalls Prevention Research <br \/>\nApproximately 1 million falls<br \/>\noccur annually in acute care<br \/>\nsettings in the United States,<br \/>\nwith incidence of 2.3-7 falls per<br \/>\n1,000 patient days (Gray-Micelli &amp;<br \/>\nQuigley, 2012; Oliver, Healey, &amp;<br \/>\nHaines, 2010). Wu, Keeler, Rubenstein,<br \/>\nMaglione, and Shekelle<br \/>\n(2010) reported estimated additional<br \/>\ncosts of $3,500 for a fall without<br \/>\ninjury, with costs increasing to<br \/>\n$16,500-$27,500 for additional falls<br \/>\nwithout injury or when serious<br \/>\ninjury occurs. In 2008, the Centers<br \/>\nfor Medicare &amp; Medicaid Services<br \/>\ndesignated falls as a hospitalacquired<br \/>\ncondition (HAC) and challenged<br \/>\nhospital reimbursement for<br \/>\nHACs deemed preventable (Quigley<br \/>\n&amp; White, 2013). Although the National<br \/>\nDatabase of Nursing Quality<br \/>\nIndicators reported falls and trauma<br \/>\ndecreased 14.7% from 2010 to 2013<br \/>\nin select hospital engagement networks,<br \/>\nwide variation remains<br \/>\nacross hospital settings.<br \/>\nOngoing research aimed at advancing<br \/>\nmethods to detect and prevent<br \/>\nfalls is important. Although<br \/>\ngeneral antecedents to falls in hospitalized<br \/>\npatients have been reported<br \/>\n(Oliver et al., 2010), their relevance<br \/>\nin the context of emergent<br \/>\nfalls prevention technologies (e.g.,<br \/>\nvideo monitoring [VM]) is not well<br \/>\nunderstood. Understanding antecedents<br \/>\nto patient falls may facilitate<br \/>\nthe design of reliable, valid<br \/>\ntools for concurrent use with VM<br \/>\ninterventions in hospital settings.<br \/>\nMaximizing the validity and reliability<br \/>\nof a VM intervention will<br \/>\nenable further testing regarding the<br \/>\nintervention s ability to reduce falls<br \/>\nand improve outcomes.<br \/>\nPurpose<br \/>\nThe purpose of this study was to<br \/>\nexplore antecedents to falls in the<br \/>\nacute care setting from the lived<br \/>\nexperiences of a diverse sample of<br \/>\nexpert health professionals, patient<br \/>\ncare assistants (1:1 safety sitters), VM<br \/>\ntechnicians, nurses, and fall prevention<br \/>\nexperts. The following research<br \/>\nquestions guided the study: (a) How<br \/>\nare the antecedents to a preventable<br \/>\nfall in patient rooms on a medical<br \/>\nunit described  (b) How do the identified<br \/>\nantecedents appear on the<br \/>\nscreen to a VM technician monitoring<br \/>\npatients on a medical unit  (c)<br \/>\nWhat are the environmental conditions<br \/>\nand patient behaviors that<br \/>\nshould precipitate fall prevention<br \/>\naction during VM <br \/>\nReview of Literature<br \/>\nA review of the relevant literature<br \/>\nwas conducted using CINAHL,<br \/>\nPubMed, Scopus, and Google<br \/>\nScholar databases. Keywords included<br \/>\nfalls, fall prevention, hospital, video<br \/>\nmonitoring, and nursing research.<br \/>\nFalls have been reported to occur<br \/>\nduring times of position change<br \/>\nand ambulation, and are often<br \/>\nunwitnessed (Deandrea et al., 2013;<br \/>\nHitcho et al., 2004; Oliver et al.,<br \/>\n2010). Therefore, emerging interventions<br \/>\nusing assistive technology<br \/>\nfor fall prevention (e.g., electronic<br \/>\nsensors, infrared sensors, fall detectors,<br \/>\nbed alerts, microphones, pressure<br \/>\nsensors, floor sensors, cameras,<br \/>\nVM) are gaining attention quickly.<br \/>\nThey provide a window through<br \/>\nwhich falls can be examined in a<br \/>\nnew way, with previously obscured<br \/>\ninformation now available regarding<br \/>\nhospital-based falls and their<br \/>\nantecedents.<br \/>\nAs one of the most recent technologic<br \/>\nadvancements, VM uses inroom<br \/>\ncameras installed at vantage<br \/>\nlocations to provide real-time viewing<br \/>\nof patient activity through computer<br \/>\nvisualization, which differs<br \/>\nRReesseeaarrcchh ffoorr PPrraaccttiiccee<br \/>\nKay Klymko, LuAnn Etcher,<br \/>\nJoan Munchiando, Mary Royse<br \/>\nThis qualitative study using focus groups of hospital personnel supports<br \/>\nknown antecedents to falls in a video monitoring (VM) setting.<br \/>\nAlthough VM can improve the understanding of behaviors<br \/>\nleading to falls, further research is needed to support VM methods.<br \/>\n330 September-October 2016   Vol. 25\/No. 5<br \/>\nfrom other forms of assistive technologies<br \/>\nused to prevent falls. VM<br \/>\nstaff members are trained to view<br \/>\nthe screen, detect an impending fall<br \/>\nevent, and intervene. In a hospitalbased<br \/>\nstudy, Hardin, Dienemann,<br \/>\nRudisill, and Mills (2013) evaluated<br \/>\nthe impact of webcams with central<br \/>\nmonitoring and alarmed virtual bed<br \/>\nrails as surveillance devices. They<br \/>\nfound a significant difference<br \/>\n(p&lt;0.05) in the fall rate per 1,000<br \/>\nadmissions. More recently, Potter<br \/>\nand co-authors (2016) analyzed<br \/>\nvideo-monitored falls in hospitalized<br \/>\npatients and found weakness<br \/>\naffecting ability to move, gait problems,<br \/>\nand occluded pathways were<br \/>\ncontributors to falls. In addition, the<br \/>\ntime between the patient beginning<br \/>\nto leave the bed and occurrence of<br \/>\nthe fall was under 2 minutes.<br \/>\nDupree, Fritz-Campiz, and Musheno<br \/>\n(2014) noted VM should be used as<br \/>\npart of a targeted solution to reduce<br \/>\nfalls in hospitalized patients who are<br \/>\nunwilling or unable to use the call<br \/>\nlight. An additional study by<br \/>\nBurtson and Vento (2015) included<br \/>\nVM as part of a fall prevention program.<br \/>\nImprovements in quality outcomes<br \/>\nand cost were demonstrated<br \/>\nover 2 years. The current study will<br \/>\nbegin to fill a gap regarding<br \/>\nantecedents to falls seen in VM, and<br \/>\nmay support development of a VM<br \/>\nintervention for further testing.<br \/>\nSample and Setting<br \/>\nParticipants were recruited using<br \/>\nfliers posted on the hospital unit,<br \/>\nand through announcements on<br \/>\nthe hospital website and at staff<br \/>\nmeetings. Interested persons contacted<br \/>\nprimary investigators (PIs)<br \/>\nwho were not affiliated with the<br \/>\nhospital. Hospital-affiliated personnel<br \/>\nwere invited to participate in<br \/>\nthe study if they were at least age<br \/>\n18; could speak English; had experience<br \/>\nas a patient care assistant (1:1<br \/>\nsafety sitter), VM technician, registered<br \/>\nnurse (RN) from the VM unit;<br \/>\nor were fall prevention experts. The<br \/>\nsample consisted of 34 participants<br \/>\nin four homogenous groups: fall<br \/>\nprevention experts (expert nurses,<br \/>\ngeriatricians [n=9]), RNs from the<br \/>\nVM unit (n=10), VM technicians<br \/>\n(n=6), and patient care assistants<br \/>\nthroughout the hospital (n=9).<br \/>\nThe study setting was an academic<br \/>\nmedical center in southeast<br \/>\nMichigan where VM had been<br \/>\nimplemented in five rooms to<br \/>\nenable concurrent VM of eight<br \/>\npatients. Patients were screened for<br \/>\nacceptance into a monitored bed by<br \/>\na group consisting of the administrative<br \/>\nmanager, director of specialty<br \/>\nprograms, and charge nurse.<br \/>\nAdmission criteria for VM (= age 65<br \/>\nwith acute illness putting the<br \/>\npatient at risk for\/exhibiting delirium,<br \/>\nor high risk for fall) were developed<br \/>\nin collaboration with unit<br \/>\ngeriatricians and nurse leaders.<br \/>\nFocus groups were conducted in<br \/>\na classroom at the hospital. Each<br \/>\nfocus group lasted approximately<br \/>\n60-90 minutes and followed a semistructured<br \/>\nformat. Groups were<br \/>\naudio-recorded and conducted by<br \/>\nthe PIs, who had no hospital affiliation;<br \/>\nfield notes also were written.<br \/>\nAfter a brief introduction, PIs used<br \/>\nseveral questions related to the<br \/>\nstudy s purpose (e.g., what behaviors<br \/>\npredict or precede a fall, how<br \/>\nwould those behaviors appear to a<br \/>\nVM technician, what specific<br \/>\nbehaviors would alert you to take<br \/>\naction to prevent a fall ).<br \/>\nThis study was approved by<br \/>\nWayne State University and the<br \/>\nstudy site s Human Investigation<br \/>\nCommittee and Institutional Review<br \/>\nBoard. Measures to assure confidentiality<br \/>\nof all shared content were<br \/>\nexplained through verbatim reading<br \/>\nof the informed consent followed by<br \/>\nparticipant consent before the focus<br \/>\ngroups.<br \/>\nMethods and Design<br \/>\nFocus group methodology was<br \/>\nconsistent with Morgan and Krueger s<br \/>\n(1998) inclusive approach.<br \/>\nAuthors defined the focus group as<br \/>\na  research technique that collects<br \/>\ndata through group interaction on a<br \/>\ntopic determined by the researcher <br \/>\nin which the  researcher s interest<br \/>\nprovides the focus, whereas the data<br \/>\nthemselves come from the group<br \/>\ninteraction  (p. 7).<br \/>\nFindings<br \/>\nAntecedents to a Preventable<br \/>\nFall<br \/>\nAntecedents to a preventable fall<br \/>\nin the patients  rooms had a clear<br \/>\ndemarcation. They were represented<br \/>\nby the major themes of environmental<br \/>\nfactors and behavioral representations.<br \/>\nChallenging Hazards within<br \/>\nthe Room<br \/>\nHazards in the room were environmental<br \/>\nfactors represented by<br \/>\nstructural and process issues. Structural<br \/>\nissues included characteristics<br \/>\nof the room itself and items in proximity<br \/>\nto patients. Process issues<br \/>\nwere related to events experienced<br \/>\nby patients.<br \/>\nStructural issues within the room.<br \/>\nParticipants agreed patient rooms<br \/>\nwere often crowded. As one patientcare<br \/>\nassistant noted,   the walker,<br \/>\nthe computers,  the table, and the<br \/>\nIV poles and the beds and it s all<br \/>\nstuffed into one room and there s<br \/>\nlike this much room (holding arms<br \/>\nup demonstrating width) to walk to<br \/>\nthe bathroom   Extreme room<br \/>\ntemperatures also were reported as<br \/>\nan issue. One fall prevention expert<br \/>\nnoted,   people are hot or cold,<br \/>\nthat s when they start pushing the<br \/>\nblankets, IV line see that a lot. <br \/>\nUnit noises can be foreign to<br \/>\npatients, occurring at variable times<br \/>\nand levels. As one RN described,<br \/>\n It s confusing for the VM patients<br \/>\nfor that voice (audio) to be in that<br \/>\nroom. <br \/>\nConcerns emerged regarding<br \/>\nlines attached or close to the<br \/>\npatient, who could become entangled<br \/>\nin or trip on them in getting<br \/>\nout of bed or ambulating (e.g., feeding<br \/>\ntube, suctioning equipment,<br \/>\nindwelling urinary catheter bag,<br \/>\nmonitoring line, intravenous line,<br \/>\ncall lights, phone line). One<br \/>\npatient-care assistant explained,<br \/>\n Tubing and the IV pole you<br \/>\nknow, you see someone starting to<br \/>\nget up and you know they re<br \/>\nhooked up to monitors and that s<br \/>\nlike, oh, no!  In addition to lines,<br \/>\npatients may try to free themselves<br \/>\nof soiled bedding or clothing, as<br \/>\nResearch for Practice<br \/>\nSeptember-October 2016   Vol. 25\/No. 5 331<br \/>\nVideo Monitoring: A Room with a View, or a Window to Challenges in Falls Prevention Research <br \/>\none VM technician said,  On midnights,<br \/>\nthey used to tell us (in staff<br \/>\neducation on fall prevention) when<br \/>\nthe patient is wet, they start trying<br \/>\nto get out of bed. <br \/>\nThe bedside table provides the<br \/>\npatient easy, routine access to personal<br \/>\nitems (e.g., cell phone, water).<br \/>\nInaccessible personal items can<br \/>\nprompt patients to reach unsafely.<br \/>\nOne patient-care assistant voiced,<br \/>\n If that s (bedside table) not near<br \/>\nthem they ll reach and then roll<br \/>\nright out\u2026 <br \/>\nVulnerable times for a fall reported<br \/>\nby participants included the day<br \/>\nof admission, day of discharge, in<br \/>\nthe morning at awakening, meal<br \/>\ntimes, shift changes, and staff<br \/>\nbreaks. Night was a particular concern,<br \/>\nas one patient-care assistant<br \/>\ndescribed,   when it gets dark, in<br \/>\nthe evening people that are completely<br \/>\nfine during the day just start<br \/>\ngetting a little confused and that s<br \/>\nwhen they ll get up they ll be<br \/>\nmore likely to fall. <br \/>\nProcess issues within the room.<br \/>\nPeople entering or leaving a<br \/>\npatient s room were reported to<br \/>\nincrease vulnerability to a fall. One<br \/>\nRN described asking the VM technician<br \/>\nto monitor patients more<br \/>\nclosely for about 5 minutes after she<br \/>\nleft the rooms because patients may<br \/>\nreconsider their needs and try to get<br \/>\nout of bed unattended without calling<br \/>\nfor help. Further validation was<br \/>\nprovided by another RN, who<br \/>\nremarked:  How many times have<br \/>\nyou heard a nurse say,  I was just in<br \/>\nthat room   <br \/>\nBehavioral Phenomena<br \/>\nExhibited by Patients<br \/>\nPatient behaviors described as<br \/>\nantecedents to falls were differentiated<br \/>\nby two sub-themes: physical<br \/>\nbehaviors and psychological\/emotional<br \/>\nphenomena.<br \/>\nPhysical behaviors exhibited by<br \/>\npatients. A behavior frequently<br \/>\ndescribed by participants was  restlessness. <br \/>\nOne fall prevention<br \/>\nexpert described   a lot of nonpurposeful<br \/>\nbehavior like picking,<br \/>\nfidgeting; picking at blankets, picking<br \/>\nat themselves, picking at the<br \/>\nlines, picking at the bed, picking at<br \/>\nwhatever may be around them<br \/>\nbefore they decide to climb out of<br \/>\nthe bed.  Participants reported,<br \/>\n The patient may sit up abruptly <br \/>\nand provide visual signals such as<br \/>\n looking around the room  or a<br \/>\n dead stare into the camera  as if to<br \/>\nsay,  Okay, who s going to see me<br \/>\nhere, can I get away   Reaching was<br \/>\nperceived to increase risk for falls,<br \/>\nwith patients described as misjudging<br \/>\nthe distance to an object. As one<br \/>\nRN explained,  A patient was sitting<br \/>\nin a chair and went to reach for<br \/>\nsomething she dropped on the<br \/>\nfloor, and just over-reached and just<br \/>\nslid right out, right under the<br \/>\ntable  <br \/>\nParticipants reported a pattern<br \/>\nand order of movements progressing<br \/>\nin magnitude\/required strength<br \/>\nas the patient prepared to get out<br \/>\nof bed. Initial fine movements<br \/>\n(e.g., restlessness, picking, looking<br \/>\naround) often were followed by<br \/>\nmore gross movement (e.g., sitting<br \/>\nup suddenly and straight, scooting<br \/>\nto the edge of the bed with the hips,<br \/>\nrolling over). Finally, as described<br \/>\nby one participant, the patient may<br \/>\nshow a  whole body and gracious<br \/>\nroll  of unprecedented strength as<br \/>\nhe or she moves out of bed.<br \/>\nIssues associated with ambulation<br \/>\nwere reported to be antecedent<br \/>\nto falls, such as improper use of<br \/>\nunfamiliar assistive devices, excessive<br \/>\nspeed in walking, foot dragging,<br \/>\nunsteadiness, syncope, and verbalizations<br \/>\nof dizziness or lightheadedness.<br \/>\nSeveral patient-care assistants<br \/>\nindicated chair sitting also can cause<br \/>\nproblems. When patients   fall<br \/>\nasleep or rest their arm over the arm<br \/>\nrest and all it takes is a slip of the<br \/>\narm and you get off balance and fall<br \/>\nforward, or push the table away<br \/>\nfrom in front of them.. , they<br \/>\nincrease their risk for fall due to<br \/>\nreduced protection from the bedside<br \/>\ntable and\/or chair arm rests.<br \/>\nPsychological and emotional behaviors<br \/>\nexhibited by patients. One RN<br \/>\ndescribed the challenge when cognitive<br \/>\nchanges occur suddenly and<br \/>\nunexpectedly (as in delirium):   <br \/>\nyou have some elderly person coming<br \/>\nin with a UTI (urinary tract<br \/>\ninfection); they get that infection<br \/>\nand they re very impaired you get<br \/>\nthe infection cleared up and then<br \/>\nthey re fine again.  Agitated or confused<br \/>\npatients often needed fears<br \/>\nallayed, as one VM technician<br \/>\nvoiced   he s crying he wants to<br \/>\nget up he wants to go home he<br \/>\njust wanted somebody to listen. He<br \/>\nwanted somebody to understand<br \/>\nhis story and once you did that, he<br \/>\nlaid back down. <br \/>\nAntecedents Appearance<br \/>\nDuring Video Monitoring<br \/>\nParticipants generally agreed VM<br \/>\ncan provide a distorted view of reality:<br \/>\n It s not as clear you can t really<br \/>\nsee what they re doing exactly. <br \/>\nHowever, they agreed VM provided<br \/>\na view otherwise unavailable unless<br \/>\nin the room. VM distortions described<br \/>\nby participants included the<br \/>\nroom appearing  far way,  partial<br \/>\nvisualization of the room, patient<br \/>\nmovements appearing as  slow<br \/>\nmotion,  lack of clarity despite<br \/>\ninfrared capability in the dark, and<br \/>\npatient behaviors appearing accentuated.<br \/>\nThese distortions led staff to<br \/>\nrespond to observed patient behavior<br \/>\n(movement) by using audio<br \/>\ncommunication to the room or<br \/>\nsending staff to the room.<br \/>\nParticipants indicated audio communications<br \/>\nactually precipitated<br \/>\nbehaviors that could lead to a fall.<br \/>\nFor example, a sleeping patient is<br \/>\nawakened with confusion and fear<br \/>\nof the  intercom voice. <br \/>\nEnvironmental Conditions<br \/>\nand Patient Behaviors<br \/>\nPrompting Action<br \/>\nParticipants identified VM antecedents<br \/>\nthat warranted increased<br \/>\nawareness or further action to avoid<br \/>\na fall. Structural environmental factors<br \/>\nincluded changes in the ambient<br \/>\nenvironment (sound and light<br \/>\nlevels, room temperature), and<br \/>\nchanges in the local environment<br \/>\n(loose or running cords, wet floors,<br \/>\npersonal care objects out of reach,<br \/>\novercrowding, room changes). Process-based<br \/>\nenvironmental factors<br \/>\nincluded changes in patterns of<br \/>\nactivity (shift change, visitors, mealtimes,<br \/>\nbeing awakened from sleep).<br \/>\nPatient-based factors prompting<br \/>\naction fell into two categories: physically<br \/>\nbased (being soiled, in pain,<br \/>\nwith sensory deficits, physiological-<br \/>\n332 September-October 2016   Vol. 25\/No. 5<br \/>\nly compromised, delirium) or psychologically\/emotionally<br \/>\nbased (dementia,<br \/>\nanxiety, presence of psychological<br \/>\ndisorders, patient unwilling<br \/>\nto follow safety parameters,<br \/>\npatient misperception of capabilities).<br \/>\nAnalysis<br \/>\nOral recordings and field notes<br \/>\nwere transcribed manually after<br \/>\neach focus group. Two PIs not affiliated<br \/>\nwith the hospital conducted<br \/>\nseparate data analyses starting with<br \/>\na first and second reading of the<br \/>\ntranscripts. Initial coding involved<br \/>\ncompressing the text based on<br \/>\nthemes (e.g., behavioral and environmental<br \/>\nconditions determined<br \/>\nto be antecedents to falls). After the<br \/>\ninitial coding scheme, a second<br \/>\nlevel of coding included an inductive<br \/>\napproach based on new knowledge<br \/>\ngained from the interviews.<br \/>\nTrustworthiness<br \/>\nLincoln and Guba s (1985) four<br \/>\ncriteria to ensure trustworthiness in<br \/>\nqualitative investigations were used<br \/>\nin this study. To assure credibility,<br \/>\nnon-hospital researchers were<br \/>\nassured by confirming the reliability<br \/>\nof the findings through comparing<br \/>\nthe consistency of the codes<br \/>\nand their thematic grouping<br \/>\nbetween the non-hospital affiliated<br \/>\nPIs. Additional peer debriefing also<br \/>\nwas obtained through a review of<br \/>\nthe collective codes\/themes by the<br \/>\nhospital PI and consultant clinical<br \/>\nnurse specialist of the research team<br \/>\nas a means to obtain further<br \/>\ninsights regarding the final thematic<br \/>\ncoding schema. Triangulation of<br \/>\nthe data also was accomplished by<br \/>\ncomparing the audio recordings of<br \/>\nthe focus groups with the field<br \/>\nnotes. Transferability of the findings<br \/>\nwas supported through use of<br \/>\npurposive sampling and the rich<br \/>\nparticipant descriptions provided in<br \/>\nthe findings. Confirmability of the<br \/>\nresults as supported by the data was<br \/>\nenhanced with a cross-comparison<br \/>\nof the decision trails used by the PIs<br \/>\nto collapse the thematic coding<br \/>\nschema. Dependability of the<br \/>\nmethodological procedures was<br \/>\nenhanced through study design<br \/>\nconsultation with an external<br \/>\nexpert in qualitative methodology.<br \/>\nLimitations<br \/>\nThe sample was restricted to selfselected<br \/>\ngroups of individuals.<br \/>\nParticipants also represented one<br \/>\nhospital setting. The study lacked a<br \/>\nfocus group of patients who had<br \/>\nexperienced a hospital fall.<br \/>\nDiscussion<br \/>\nVideo-monitoring technology<br \/>\nprovides an intervention not previously<br \/>\navailable to healthcare<br \/>\nproviders. This study was a beginning<br \/>\nelucidation of the appearance<br \/>\non a VM screen of many of the<br \/>\nknown antecedents to falls in<br \/>\npatient rooms. Focus group participants<br \/>\nin this study identified<br \/>\nantecedents to hospital falls generally<br \/>\nconsistent with patient-specific<br \/>\nfactors and environmental risk factors<br \/>\nas previously identified in the<br \/>\nliterature; this expanded prior work<br \/>\non knowledge of antecedents<br \/>\n(Deandrea et al., 2013; Oliver et al.,<br \/>\n2010) and confirmed its relevancy<br \/>\nin a VM inpatient environment.<br \/>\nNursing Implications<br \/>\nThis study s findings may inform<br \/>\nnurses who are planning to implement<br \/>\na VM intervention in their<br \/>\nhospitals. Although the Morse Fall<br \/>\nScale was demonstrated as effective<br \/>\nin predicting falls when used in a<br \/>\nVM inpatient setting (Hardin et al.,<br \/>\n2013), neither that scale nor the<br \/>\nSTRATIFY falls risk assessment tool<br \/>\nwas designed as a decisional aid for<br \/>\ndetermining the best strategy to<br \/>\nprevent falls for at-risk individuals.<br \/>\nMoreover, neither of these assessment<br \/>\ntools includes an indicator<br \/>\n(e.g., specific diagnosis of delirium<br \/>\nor dementia) that may guide the<br \/>\ndecision to use a VM intervention<br \/>\nversus a different modality (e.g., 1:1<br \/>\nsafety sitter). Nurses may believe<br \/>\nthese diagnoses are appropriate for<br \/>\na VM intervention, but this study<br \/>\nsuggests nurses must remain cautious<br \/>\nwhen initiating audio communications<br \/>\nfrom the VM central<br \/>\nstation to patients who are prone to<br \/>\ndifficulty with dual-tasking (e.g.,<br \/>\ncognitive aging or impairment).<br \/>\nFurther investigations are needed<br \/>\non the characteristics of patients<br \/>\nwho may be best served by VM.<br \/>\nConclusion<br \/>\nThe availability of VM in inpatient<br \/>\nunits provides new opportunities<br \/>\nto understand how known<br \/>\nantecedents are viewed and prompt<br \/>\naction in the context of a VM intervention.<br \/>\nThe findings from this<br \/>\nstudy add to existing knowledge,<br \/>\nwhich can be applied to developing<br \/>\nand refining VM interventions to<br \/>\nprevent falls. Further investigations<br \/>\nconducted with real-time VM designed<br \/>\nto describe and validate<br \/>\nreported antecedents to falls are<br \/>\nneeded, despite the inherent methodological<br \/>\ndifficulties in designing<br \/>\nand conducting VM research studies<br \/>\n(Hardin et al., 2013). Additionally,<br \/>\nfurther investigation of<br \/>\nwhat constitutes an appropriate,<br \/>\nsafe VM intervention response is<br \/>\nwarranted in light of the finding<br \/>\nthat certain VM intervention<br \/>\nresponses (audio speaker to the<br \/>\npatient) may trigger a fall in some<br \/>\npatients. Until then, nurses will<br \/>\nneed to consider carefully personal<br \/>\ncharacteristics of patients when<br \/>\nadmitting patients to a VM unit and<br \/>\nresponding to potential antecedents<br \/>\nto falls detected during a VM<br \/>\nintervention.<br \/>\nREFERENCES<br \/>\nBurtson, P.L., &amp; Vento, L. (2015). Sitter reduction<br \/>\nthrough mobile video monitoring: A<br \/>\nnurse-driven sitter protocol and administrative<br \/>\noversight. Journal of Nursing<br \/>\nAdministration, 45(7\/8), 363-369.<br \/>\nDeandrea, S., Bravi, F., Turati, F., Lucenteforte,<br \/>\nE., La Vecchia, C., &amp; Negri, E.<br \/>\n(2013). Risk factors for falls in older people<br \/>\nin nursing homes and hospitals. A<br \/>\nsystematic review and meta-analysis.<br \/>\nArchives of Gerontology and Geriatrics,<br \/>\n56(3), 407-415.<br \/>\nDuPree, E., Fritz-Campiz, A., &amp; Musheno, D.<br \/>\n(2014). A new approach to preventing<br \/>\nfalls with injuries. Journal of Nursing<br \/>\nCare Quality, 29(2), 99-102.<br \/>\nGray-Micelli, D., &amp; Quigley, P.A. (2012). Falls<br \/>\nprevention: Assessment, diagnosis, and<br \/>\nintervention strategies. New York, NY:<br \/>\nHartford Institute for Geriatric Nursing.<br \/>\nResearch for Practice<br \/>\nSeptember-October 2016   Vol. 25\/No. 5 333<br \/>\nHardin, S., Dienemann, J., Rudisill, P., &amp; Mills,<br \/>\nK.K. (2013). Inpatient fall prevention:<br \/>\nUse of in-room webcams. Journal of<br \/>\nPatient Safety, 9(1), 29-35.<br \/>\nHitcho, E.B., Krauss, M.J., Birge, S., Dunagan,<br \/>\nW.C., Fischer, I., Johnson, S.,   Fraser,<br \/>\nV.J. (2004). Characteristics and circumstances<br \/>\nof falls in a hospital setting: A<br \/>\nprospective analysis. Journal of General<br \/>\nInternal Medicine, 19(7), 732 739. doi:<br \/>\n10.1111\/j.1525-1497.2004.30387.x<br \/>\nLincoln, Y.S., &amp; Guba, E.G. (1985). Naturalistic<br \/>\ninquiry. Newbury Park, CA: Sage Publications.<br \/>\nMorgan, D.L., &amp; Krueger, R.A. (1998). The<br \/>\nfocus group kit. Thousand Oaks, CA:<br \/>\nSage.<br \/>\nOliver D., Healey, F., &amp; Haines, T.P. (2010).<br \/>\nPreventing falls and fall-related injuries in<br \/>\nhospitals. Clinics in Geriatric Medicine,<br \/>\n26(4), 645-692. doi:10.1016\/j.cger.2010.<br \/>\n06.005<br \/>\nPotter, P., Allen, K., Costantinou, E.,<br \/>\nKlinkenberg, D., Malen, J., Norris, T., \u2026 &amp;<br \/>\nTymkew, H.H. (2016). Anatomy of inpatient<br \/>\nfalls: Examining fall events captured<br \/>\nby depth-sensor technology. The Joint<br \/>\nCommission Journal on Quality and<br \/>\nPatient Safety, 42(5), 225-232.<br \/>\nQuigley, P., &amp; White, S., (2013). Hospitalbased<br \/>\nfall program measurement and<br \/>\nimprovement in high reliability organizations.<br \/>\nOnline Journal of Issues in<br \/>\nNursing, 18(2), Manuscript 5. doi:10.<br \/>\n3912\/OJIN.Vol18No02Man05<br \/>\nWu, S., Keeler, E., Rubenstein, L., Maglione,<br \/>\nM.A., &amp; Shekelle, P.G. (2010). A costeffectiveness<br \/>\nanalysis of a proposed<br \/>\nnational falls prevention program.<br \/>\nClinical Geriatric Medicine, 26(4), 751-<br \/>\n766. doi:10.1016\/j.cger.2010.07.005<br \/>\nCopyright of MEDSURG Nursing is the property of Jannetti Publications, Inc. and its content<br \/>\nmay not be copied or emailed to multiple sites or posted to a listserv without the copyright<br \/>\nholder\u2019s express written permission. However, users may print, download, or email articles for<br \/>\nindividual use.<\/p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Description For this assignment you will: 1. review the 2 current and trustworthy\/scholarly research articles on a relevant patient safety topic (you are not to use articles\/readings reviews that you ve obtained from another student this exercise is to help <a href=\"https:\/\/www.benedictsol.com\/blogs\/evidencedbasedarticlesthatpromotepatientsafety\/\" class=\"read-more\">Read More &#8230;<\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-95826","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts\/95826","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/comments?post=95826"}],"version-history":[{"count":0,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts\/95826\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/media?parent=95826"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/categories?post=95826"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/tags?post=95826"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}