1. Evaluation Table
Use this document to complete the evaluation table requirement
of the Module 4 Assessment,Evidence-Based Project, Part 4A:
Critical Appraisal of Research
Full citation of selected article
Article #1
Article #2
Article #3
Article #4
Conceptual Framework
Describe the theoretical basis for the study
Design/Method Describe the design
and how the study
was carried out
Sample/Setting

2. The number and
characteristics of
patients,
attrition rate, etc.
Major Variables Studied
List and define dependent and independent variables
Measurement
Identify primary statistics used to answer clinical questions
Data Analysis
Statistical or
qualitative
findings
Findings and Recommendations
General findings and recommendations of the research

3. Appraisal
Describe the general worth of this research to practice. What are
the strengths and limitations of study? What are the risks
associated with implementation of the suggested practices or
processes detailed in the research? What is the feasibility of
use in your practice?
General Notes/Comments
Levels of Evidence Table
Use this document to complete the levels of evidence table
requirement of the Module 4 Assessment,Evidence-Based
Project, Part 4A: Critical Appraisal of Research
Author and year of selected article
Article #1
Article #2
Article #3
Article #4
Study Design

4. Theoretical basis for the study
Sample/Setting
The number and
characteristics of
patients
Evidence Level *
(I, II, or III)
Outcomes
General Notes/Comments

5. * Evidence Levels:
· Level I
Experimental, randomized controlled trial (RCT), systematic
review RTCs with or without meta-analysis
· Level II
Quasi-experimental studies, systematic review of a combination
of RCTs and quasi-experimental studies, or quasi-experimental
studies only, with or without meta-analysis
· Level III
Nonexperimental, systematic review of RCTs, quasi-
experimental with/without meta-analysis, qualitative,
qualitative systematic review with/without meta-synthesis
· Level IV
Respected authorities’ opinions, nationally recognized expert
committee/consensus panel reports based on scientific evidence
· Level V
Literature reviews, quality improvement, program evaluation,
financial evaluation, case reports, nationally recognized
expert(s) opinion based on experiential evidence
Outcomes Synthesis Table
Use this document to complete the outcomes synthesis table
requirement of the Module 4 Assessment,Evidence-Based
Project, Part 4A: Critical Appraisal of Research
Author and year of selected article
Article #1
Article #2
Article #3

6. Article #4
Sample/Setting
The number and
characteristics of
patients
Outcomes
Key Findings
Appraisal and Study Quality
General Notes/Comments

7. Critical Appraisal Tools Worksheet Template
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Walden University :Nurs-6052
Matrix Worksheet Template
Use this document to complete Part 2 of the Module 2
Assessment, Evidence-Based Project, Part 1: An Introduction to
Clinical Inquiry and Part 2: Research Methodologies
Full citation of selected article
Article #1
Article #2
Article #3
Article #4
Hempel, S., Newberry, S., Wang, Z., Booth, M., Shanman, R.,
Johnsen, B., & Ganz, D. A. (2017). Hospital fall prevention: a
systematic review of implementation, components, adherence,
and effectiveness. Journal of the American Geriatrics Society,
61(4), 483-494.
DiBardino, D., Cohen, E. R., & Didwania, A. (2014).
Meta‐analysis: multidisciplinary fall prevention strategies in the
acute care inpatient population. Journal of hospital
medicine, 7(6), 497-503.

8. Haines, T. P., Hill, K. D., Bennell, K. L., & Osborne, R. H.
(2017). Additional exercise for older subacute hospital
inpatients to prevent falls: benefits and barriers to
implementation and evaluation. Clinical Rehabilitation, 21(8),
742-753.
Spiva, L., & Hart, P. (2014). Evidence-Based Interventions for
Preventing Falls in Acute Care Hospitals.
Why you chose this article and/or how it relates to the clinical
issue of interest (include a brief explanation of the ethics of
research related to your clinical issue of interest)
Intercession elements intended for all patients were separated
from care plans for person's identified as being at great danger
of falling. Data on approaches cultivating adherence to the
implemented care procedures were documented, and information
on the intercession fidelity was removed.
When inpatient falls, adverse effects such as injuries follows,
which increases the time spent in the hospital and ballooning
health care cost. General fall avoidance measures have been
proposed and have been deemed as effective approaches. Along
these lines, I picked this article to support the fact that
compelling endeavors ought to be made to maintain and
safeguard the wellbeing of all patients. The prevention ought to
be the essential concentration and ought to be focused on
decreasing fall rates. To reduce the number of inpatient falls,
healthcare specialist must apply different multidisciplinary
strategies and interventions. Before applying these changes,
ethical issues should be considered to preserve their safety and
their rights considered. In this case, the hospital opts to use a
positioning belt and chair safety belt as examples of safety
interventions strategies. Guidelines and procedures when
connecting the belts should be followed, as explained by the fall
prevention protocol and interventions policy. The belt is
attached when a patient shows he/she can remove it or when
he/she shows some indication that he/she needs some assistance.
The belt helps to keep the patient remain in the position away

9. from sliding or coming out of the chair. The belt attachment
applies best for the patients with mental problems, but those
with a sober mind, do not require the belt.
I selected this article because it is considered essential to do a
systematic survey for individuals to get the knowledge behind
the science on all avoidance in healthcare settings as falls
contributes to many reported cases of increased morbidity and
mortality.
Outcomes will illuminate medical care experts, scientists,
policymakers, caretakers, and clients. The ethical issue
considered during exercise for older sub-acute medical clinic
inpatients to counteract falls shows ambivalent perspectives on
the target populace concerning fall risk and the need for fall
avoidance. The ability to take up preventive measures relies
upon a variety of personal factors, the nature of data, guidance,
and decision-making, the prevention program itself, and social
help.
The purpose behind picking this article is because falls are the
most much of the time reported safety event among the United
States hospitalized patients. Average hospital budget for
reducing the morbidity and increased mortality risk is estimated
to be $20 billion per year. Patient’s safety, whereby units
prepared rooms for patient’s examination, was kept safe and
secure. Patient safety was an ethical issue that was considered.
Alongside a safe environment for a patient, a non-reusable fall
prevention pack was applied for patients diagnosed with a high
risk of a fall.
Brief description of the aims of the research of each peer-
reviewed article
Hempel at al carried out this exploration where they used a
prevention resource guide tool to assist the enhancement of
clinic falls. The authors were determined to review the
characteristics of different tools used in the hospital to prevent
falls.
DiBardino, Cohen and Didwania conducted this research with

10. the aim of promising safe and quality healthcare delivery to the
patients by: minimizing injury fatalities for in-patients,
litigations involved, health care cost, as well as reducing the
time spent in the hospital. Authors used clinical evidence-based
information to examine accessible information as well as
assessing a multidisciplinary fall prevention program in acute
impatient environment.
The research was conducted with the aim of evaluating the
efficiency of implemented falls prevention exercise program
purposed to minimize the number of elderly falls in the sub-
acute unit environment.
Spiva and Hart carried this examination with the purpose of
analyzing the development initiative in medical care facility.
The viability of an action prevention program to minimize fall
rates was also reviewed by authors where they used a fall
prevention kit to minimize fall rates in the hospital.
Brief description of the research methodology used Be sure to
identify if the methodology used was qualitative, quantitative,
or a mixed-methods approach. Be specific.
A qualitative method was used by authors where they analyzed
and recorded the reported that was based on the interventions
placed to reduce the number of elderly falls in the hospital. By
incorporating online resources and information, an account was
provided by authors that the introduced equipment and tools
reduced nurse’s injuries and improved patient safety. The name
of the equipment and devices used were additionally included
on top of the reliability and validity information that was
abstracted from the qualitative approach applied.
Authors used a qualitative method when they were conducting
their research. They used different search engine and databases
such as the library, EMBAE, Cinahl, and literature of medicine
to get information. Control fall measures on patients, inpatients,
incidental preventions, and coincidental falls were some of the
medical subjects used by authors during the study. Primary

11. research studies associated with inpatient falls were the one
incorporated into the examination. The results were analyzed,
and it was deduced that the fall rate in the specialist’s room was
1000 patients per day. The authors got assurance intervals from
individual examinations.
A quantitative method was used by authors using a subgroup
examination. Participants were selected from a modern sub-
acute/aged rehabilitation facility and were enlisted for a falls
prevention action program in the section of a bigger randomized
controlled trial. Both the inpatient and control fall participants,
totaling 11 intervention groups were approved for this program
and were monitored during their stay in the hospital to
determine whether the falls occurred or not. During their
referrals and after being discharged from the hospital,
participants were examined for their balance, quality, and
mobility. Also, performance status for each participant was
recorded.
The research was conducted using a qualitative study where
authors led one-day training before implementing the program.
The purpose of these training units was to allow each group to
identify a person showing the highest commitment effort to fall
prevention. The potential person identified had to fulfill some
task like managing any upcoming imaginable change within the
group, build and encourage the group as well as being the leader
of the group. Each unit was responsible for monitoring and
assessing the groups on a routine basis. Electronic fall hospital
database was used by each unit to track fall incidences that
included; fall characteristics, strategies that have used by nurses
to prevent falls, chances of falling, as well as assessment
scores. Eight nursing units were identified from the national
database nursing quality indicators, which were analyzed and
used to direct fall rates from four community medical clinics.
The fall balancing activity system included fall avoidance pack
used to rate the fall cases, facility planning, group designing the
activity, and line staff guidance.
A brief description of the strengths of each of the research

12. methodologies used, including reliability and validity of how
the methodology was applied in each of the peer-reviewed
articles you selected.
Findings were done to recognize whether the instrument had
been utilized before in an acute care medical facility or in the
event that it had been a piece of validity and reliability
assessment. Adherence methodologies are of specific
significance for long haul changes. Initial achievement probably
won't be kept up on the grounds that adherence to introduced
care procedures blurs in clinical practice, utilization of the
introduced risk evaluation instrument may not be supported, and
prescribed measures may never again be systematically
connected.
A broad eligibility criterion was incorporated in the study and
questions were clearly reviewed and addressed. Authors used
different languages to search for information on the electronic
database search box.
The strength of the randomized controlled trial used an
additional exercise program provided notwithstanding standard
care that aided in the prevention of falls in the sub-acute
medical clinic setting. Attendants should exploit this
examination and use exercise programs notwithstanding normal
care to prevent falls. New and inventive approaches to utilize
exercise as an intervention could likewise be utilized for the
patient's plan of care.
A narrative summary was the strength of the investigation since
it was utilized to report the discoveries that revealed a reduction
in cases identified with fall prevention action unit and executing
training. Patients were represented to encounter an infrequent
perplexity, limited transferability, and high-risk drug that
elevated rates of falling for patients admitted in neurology unit.
General Notes/Comments
Fall prevention programs have demonstrated to be best when
there are a few elements, and all individuals from the care team

13. are engaged to act in delivering safe patient care. The
achievement of the fall prevention program relies upon the
program itself as well as on the practical application,
commitment, and training of the staff involved. The nursing
leadership can be the main impetus to actualize change on a
significant systematic level by following, tracking, detailing,
and examining components to prevent further patient mischief.
The general effect of a patient fall bringing about an injury can
catastrophically affect the patient, their wellbeing, knowledge,
and a financial burden on the facility.
Fall prevention strategies had a small effect but a significant
statistical impact on fall rates irrespective of the application of
multifaceted, multidisciplinary interventions. What the study
also applied is the randomized trials that were required to assess
different potential benefits associated with multidisciplinary
approaches used to prevent falls in the acute in-patient
environment.
Medical care practitioners prescribe vitamin D supplements to
reduce the fall rate. It is deemed viable for exercises used in the
acute care clinic; though it remains uncertain for its
appropriateness use in the hospital due to conflicting results
associated with potential interventions conflict of reliance. In
hospitals, multidisciplinary interventions have been seen to
reduce the rate of falls, even though the risk associated with
fallen remain unclear. It was uncertain also that multifactorial
interventions in lessening the number of falls should be
recommended as the best method.
In rundown, the aftereffects of our examination demonstrate
that a HIT intercession focusing on underlying regions of threat
can prevent patient falls in older patients in acute care medical
clinics. Likewise, the clinic understood that making of a
situation that cultivates a workplace where staff and leaders are
made responsible would give great help to fall avoidance.

14. Matrix Worksheet Template
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