Strategies for Dissemination of EBP
In their article, Leeman & Sandelowski (2012) explore methodologies for use in qualitative research. One of the methodologies explored in the article is identifying causal mechanisms. Leeman & Sandelowski (2012) argue that qualitative studies are easily amenable to have them uncover causal mechanisms, thus contributing to building a theory that explains how a given intervention impacts targeted outcomes.
An intervention PICOT question supporting the chosen methodology is as follows:
- Does the use of restraints over a prolonged period help to reduce the occurrence of falls in patients aged 65 and over?
The intervention in the above question is the use of restraints. There are various strategies to disseminate this intervention. One of the strategies is having bed rails for patients determined to be at risk of falls and fall-related injuries. In this approach, two full rails or four half-rails can be installed on the patient’s bed thereby restricting movement and possible fall incidences (Ng, McMaster, & Heng, 2008). The bed rails are adjustable metal bars available in different sizes and shapes. At times, rigid plastic bars can also be used.
The use of bedrails as physical restraint would help to reduce the occurrence of falls in patients aged 65 and over. The strategy would do so by limiting the patient’s movement, which has received criticism as it is seen as an infringement of patients’ rights to decision-making and free movement (Oliver, 2002). It is advised that the strategy should be used as a last resort after other strategies used to prove to be ineffective.
The selected methodology from the article is identifying the causal mechanism. The PICOT question developed in this regard is whether the use of restraints over a prolonged period helps to reduce the occurrence of falls in patients aged 65 and over. Installation of bedrails would be appropriate as it would restrict or limit movement that would result in falls and fall-related injuries.
Leeman, J., & Sandelowski, M. (2012). Practice‐based evidence and qualitative inquiry. Journal of Nursing Scholarship, 44(2), 171-179.
Ng, K., McMaster, F., & Heng, B. (2008). The effectiveness of bedrails in preventing falls. Singapore Nurs J, 35(4), 10-17. Retrieved from https://corp.nhg.com.sg/HSOR/Documents/The%20effectiveness%20of%20bedrails%20%5BKok%20Ping%5D.pdf
Oliver, D. (2002). Bed falls and bedrails—what should we do? Age and ageing, 31(5), 415-418. Retrieved from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.1020.9939&rep=rep1&type=pdf