As the senior editor, I find the ‘Fall prevention program’ to be vital in creating awareness of existing patient falls. The proposal should be published because it contains a lot of information that is beneficial to all the readers whether they are in the health care industry or not. It will be appropriate in finding out whether a simple, low cost intervention can help prevent patients from falling, thus leading to a decrease in a unit’s fall rate.
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The readers will also get a chance to benefit by being in a position to understand that hospitalized patients can be prevented from suffering injuries caused by accidental falls. Based on your proposal, I find the content helpful in building a concept of patient and family education as a key component of a fall prevention program. If this study is published it will help determine if the findings can be translated to other acute care areas or if the diversity of patients in other types of units precludes its success.
The proposal will create a challenge facing many hospitals and concerned stakeholders in finding out if patient education is improved, the likelihood of patient falls will reduce. It will also provide an additional “tool” for units to utilize and reduce their fall rates. The cost for implementing the program is minimal and the potential financial benefits to the hospital are dependent on the degree of reduction in falls. This is only helpful if the main reason is lack of accuracy in predicting which patients were at high risk for falls. The findings of this study may provide support for focusing on all patients, not just those at risk.
According to your proposal, it is reasonable to conclude a novel approach is needed to effectively prevent falls in oncology patients. Traditional characteristics of patients who fall are often not present in oncology patients or are transient in nature. Looking at interventions not requiring identification of those at risk may offer increased protection for the population as a whole by treating everyone as being at increased risk of falling.
The measurement and data collection plan are also credible as it involves three phases: the pre-intervention phase lasting six months, the intervention period, lasting one month and the post-intervention lasting six to twelve months. During the intervention period, the nursing staff will receive education on the requirement for daily reinforcement of initial fall teaching. Audits will be conducted to ensure at least 90% of the patients receive daily education. If compliance falls below 90%, reminders will be sent to staff and individual staff members may receive counseling if they are noted to routinely not provide daily education. The length of the post-intervention period will be determined following an interim analysis of monthly and quarterly fall rates six months after the intervention period.
If the proposed interim analysis shows any decrease in either the monthly or quarterly fall rates, the study will be extended for an additional six months. The rationale for the extension is to better determine if the observed decrease is related to the educational intervention and if the intervention can be sustained over time. During this time, all adult patients over the age of sixteen who are responsive and admitted to inpatient status will be included in the study. This will be a good way of measuring and collecting data as it will prove to the readers that the study was done in a manner aimed at ensuring accuracy.
However, it will be important to note that the publication has the potential to affect the patient population and the new population may have a lower risk of falling. But this cannot be guaranteed at any time. To allow for the assessment of potential changes in the patient population, data should be collected during the study period related to the characteristics of the patients. The data points should include age, sex, diagnosis, treatment phase and the Schmidt fall assessment scores. Data for each period of the study will be analyzed for the mean age, and the distribution of age, sex, diagnosis, treatment phase and the Schmidt scores. Data collected during the study will also be compared to historical unit data to determine if there are significant changes in the patient population.
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