Medical-Surgical Nursing Study Set 1

Nursing

Quiz 4 :

Evidence-Based Practice in Health Care

Quiz 4 :

Evidence-Based Practice in Health Care

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An 82-year-old alert and oriented woman was admitted with a diagnosis of congestive heart failure. She also has urinary frequency. You notice on her chart that she is a "high falls risk." Over 70% of patients on your unit are also at high risk for falls. The written policy and procedure for fall prevention at your hospital states that patients at risk for falling should have: • Their health care record flagged with a yellow flower • A yellow flower placed on their room or bed • A bed alarm installed • Their siderails up at all times, except when a visitor, nurse, or nursing assistant is present The patient felt the urge to urinate and pressed her call light. Someone on the intercom told her that she would assist her shortly. After 15 minutes, the patient had to make a decision to either urinate in bed or climb over the siderails to go to the bathroom. She decided to climb over the siderails and fell. The bed alarm went off after she left the bed. Considering that over 70% of patients admitted to your unit are flagged as "at risk for falls," how do you think the nurses decide that a patient is at risk for falling? Are they using valid, reliable, sensitive, and specific assessment tools to make this determination?
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An old patient was admitted with congestive heart failure. She also suffers from urinary frequency. An additional diagnosis is that she has a risk for falls.
The nurses follow the process of EPB for deciding whether a patient is at risk of falling. They are using valid and specific assessment tools to determine the risk of a patient.
The process includes several steps:
• Asking burning clinical questions
• Finding the best evidence
• Critically checking and synthesizing relevant evidence
• Carrying out accepted recommendations
• Evaluation of the outcome
So, the nurses can ask the patients themselves. They can find the evidence by watching the patient closely. They can check the evidence and frequency of the falls. They can carry out the required actions for the patient like adding rails to the bed.
The evaluation of the outcome can be seen by observing the patient. Also, each patient behaves in a different way.

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An 82-year-old alert and oriented woman was admitted with a diagnosis of congestive heart failure. She also has urinary frequency. You notice on her chart that she is a "high falls risk." Over 70% of patients on your unit are also at high risk for falls. The written policy and procedure for fall prevention at your hospital states that patients at risk for falling should have: • Their health care record flagged with a yellow flower • A yellow flower placed on their room or bed • A bed alarm installed • Their siderails up at all times, except when a visitor, nurse, or nursing assistant is present The patient felt the urge to urinate and pressed her call light. Someone on the intercom told her that she would assist her shortly. After 15 minutes, the patient had to make a decision to either urinate in bed or climb over the siderails to go to the bathroom. She decided to climb over the siderails and fell. The bed alarm went off after she left the bed. In a population of inpatient older adults, what factors can predict patient falls with a high degree of accuracy?
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An old patient was admitted with congestive heart failure. She also suffers from urinary frequency. An additional diagnosis is that she has a risk for falls. She climbed over the rails of her bed to go to the bathroom and fell down.
In a population of inpatient older adults, the factors which can predict fall of patients with a high degree of accuracy:
• Old age
• Gait and balance impairment
• Urinary incontinence
• Use of laxatives and antipsychotics
• Disorientation

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An 82-year-old alert and oriented woman was admitted with a diagnosis of congestive heart failure. She also has urinary frequency. You notice on her chart that she is a "high falls risk." Over 70% of patients on your unit are also at high risk for falls. The written policy and procedure for fall prevention at your hospital states that patients at risk for falling should have: • Their health care record flagged with a yellow flower • A yellow flower placed on their room or bed • A bed alarm installed • Their siderails up at all times, except when a visitor, nurse, or nursing assistant is present The patient felt the urge to urinate and pressed her call light. Someone on the intercom told her that she would assist her shortly. After 15 minutes, the patient had to make a decision to either urinate in bed or climb over the siderails to go to the bathroom. She decided to climb over the siderails and fell. The bed alarm went off after she left the bed. Does the best available evidence support the use of bed alarms as an intervention that prevents falls in inpatient adults of any age?
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An old patient was admitted with congestive heart failure. She also suffers from urinary frequency. An additional diagnosis is that she has a risk for falls. She climbed over the rails of her bed to go to the bathroom and fell down.
Yes, bed alarms can prevent falls to some extent in the elderly. In people of other ages it can work well, but in elderly patients, it can work only to some extent. A nurse has to be nearby, preferably in the next room. Since, they cannot control urine for a long time, alarm switches can help only to some extent.
Yes, the best evidence proves that bed alarms are useful in preventing a certain percentage of falls.

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An 82-year-old alert and oriented woman was admitted with a diagnosis of congestive heart failure. She also has urinary frequency. You notice on her chart that she is a "high falls risk." Over 70% of patients on your unit are also at high risk for falls. The written policy and procedure for fall prevention at your hospital states that patients at risk for falling should have: • Their health care record flagged with a yellow flower • A yellow flower placed on their room or bed • A bed alarm installed • Their siderails up at all times, except when a visitor, nurse, or nursing assistant is present The patient felt the urge to urinate and pressed her call light. Someone on the intercom told her that she would assist her shortly. After 15 minutes, the patient had to make a decision to either urinate in bed or climb over the siderails to go to the bathroom. She decided to climb over the siderails and fell. The bed alarm went off after she left the bed. In a population of adult inpatients, what are the factors that have been shown by research to be the most predictive of falls?
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An 82-year-old alert and oriented woman was admitted with a diagnosis of congestive heart failure. She also has urinary frequency. You notice on her chart that she is a "high falls risk." Over 70% of patients on your unit are also at high risk for falls. The written policy and procedure for fall prevention at your hospital states that patients at risk for falling should have: • Their health care record flagged with a yellow flower • A yellow flower placed on their room or bed • A bed alarm installed • Their siderails up at all times, except when a visitor, nurse, or nursing assistant is present The patient felt the urge to urinate and pressed her call light. Someone on the intercom told her that she would assist her shortly. After 15 minutes, the patient had to make a decision to either urinate in bed or climb over the siderails to go to the bathroom. She decided to climb over the siderails and fell. The bed alarm went off after she left the bed. What interventions have been shown to decrease the fall rates in acute care institutions with this population?
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