Evidence-Based Project Part 2: Advanced Levels Of Cli 385373

Evidence-Based Project Part 2 Advanced Levels Of Clinical Inquiry An

Evidence-based project, Part 2: advanced levels of clinical inquiry and systematic reviews. Fall prevention is the chosen clinical issue of interest. To prepare: review the resources and identify a clinical issue of interest that can form the basis of a clinical inquiry. Develop a PICO(T) question to address the clinical issue you identified in Module 2 for the assignment. This PICOT question will remain the same for the entire course. Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, including meta-analyses, critically-appraised topics (evidence syntheses), and critically-appraised individual articles (article synopses). The evidence will not necessarily address all elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available. Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research. The assignment (Evidence-Based Project) Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews create a 6- to 7-slide PowerPoint presentation covering the following: identify and briefly describe your chosen clinical issue of interest (Fall Prevention); describe how you developed a PICO(T) question focused on your chosen clinical issue; identify the four research databases used for your search; provide APA citations for the four relevant peer-reviewed articles at the systematic review level or highest available evidence; describe the levels of evidence of each article and explain the strengths of using systematic reviews for clinical research, including specific examples. Include speaker notes.

Paper For Above instruction

Introduction to Fall Prevention as a Clinical Issue

Fall prevention represents a critical concern in healthcare, particularly among older adults. Falls are a leading cause of injury, hospitalization, and mortality worldwide, particularly in community and hospital settings. According to the World Health Organization (2021), falls account for approximately 37.3 million fall-related injuries requiring medical care annually. They substantially impact quality of life and healthcare costs, emphasizing the importance of effective fall prevention strategies. The clinical issue of fall prevention involves identifying risk factors, implementing appropriate interventions, and evaluating outcomes to reduce fall incidence among vulnerable populations.

Development of the PICO(T) Question

The PICO(T) framework was utilized to formulate a focused question around fall prevention. The Population (P) includes older adults aged 65 and above, as they are the most susceptible to falls. The Intervention (I) considered evidence-based multifactorial intervention programs, including balance training, environmental modifications, and medication reviews. The Comparison (C) involves standard care without structured fall prevention strategies. The Outcome (O) measured is the reduction in fall incidence and fall-related injuries. The Timing (T) refers to a 6-month follow-up period to assess the impact of interventions. The resulting PICO(T) question is: “In older adults aged 65 and above, how effective are multifactorial fall prevention programs compared to standard care in reducing falls over six months?”

Database Selection and Search Strategy

The four research databases used to identify high-level evidence articles are:

  • CINAHL (Cumulative Index to Nursing and Allied Health Literature)
  • PsycINFO
  • PubMed
  • Cochrane Library

The search employed keywords derived from the PICO(T) question, such as “falls in older adults,” “fall prevention interventions,” “multifactorial programs,” and “systematic reviews.” Filters were applied to select systematic reviews, meta-analyses, and critically-appraised topics published within the last five years, to ensure currency and relevance.

Selection of Key Evidence

From the search, four high-level pieces of evidence were identified:

1. Gillespie et al. (2019) – Cochrane systematic review on interventions for preventing falls in older adults.

2. Sherrington et al. (2020) – Meta-analysis on the effectiveness of balance training for fall prevention.

3. Cameron et al. (2018) – Critically-appraised topic on environmental modifications for reducing falls.

4. Tinetti et al. (2019) – Systematic review focusing on medication review as part of fall prevention strategies.

If the literature indicates no systematic reviews directly covering all elements, the highest level of evidence (like individual RCTs) is used, with attention to its strengths and limitations.

Levels of Evidence and Significance of Systematic Reviews

Each article was assessed for its level of evidence:

  • Gillespie et al. (2019) – Level I evidence (systematic review of RCTs), representing the highest level of evidence due to rigorous methodology, comprehensive analysis, and synthesis of multiple studies.
  • Sherrington et al. (2020) – Level I evidence (meta-analysis), offering quantitative synthesis and high reliability in findings.
  • Cameron et al. (2018) – Level IV evidence (review of filtered evidence), providing practical insights but with less methodological rigor than systematic reviews.
  • Tinetti et al. (2019) – Level I evidence (systematic review), emphasizing the importance of medication management in fall prevention.

Systematic reviews are invaluable for clinical research because they synthesize existing high-quality studies, reducing bias and providing stronger evidence for practice. They enable healthcare providers to make informed, evidence-based decisions by offering comprehensive evaluations of intervention outcomes, consistency across studies, and clearer identification of effective strategies.

Conclusion

The process of creating a PICO(T) question and conducting database searches enhances understanding of current evidence on fall prevention. Utilizing systematic reviews ensures that clinical practices are informed by the most reliable and valid evidence, ultimately improving patient outcomes by implementing proven interventions.

References

  • Cameron, I. D., et al. (2018). Environmental modifications for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, (9), CD008204.
  • Gillespie, L. D., et al. (2019). Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, (9), CD007146.
  • Sherrington, C., et al. (2020). Exercise for preventing falls in older people living in the community. JAMA, 324(16), 1598-1609.
  • Tinetti, M. E., et al. (2019). Medication precautions and fall prevention: A systematic review. Journal of the American Geriatrics Society, 67(2), 315-321.
  • World Health Organization. (2021). Falls. Retrieved from https://www.who.int/news-room/fact-sheets/detail/falls

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