B.  Selecting a research-based article that answers My EBP question from part A2 to conduct an evidence appraisal. Article: de Jong, L. D., Weselman, T., Kitchen, S., & Hill, A. M. (2020). Exploring hospital patient sitters' fall prevention task readiness: A cross‐sectional survey. Journal of Evaluation in Clinical Practice, 26(1), 42-49.

According to de Jong et al. (2020), falls are a significant public health challenge that increases healthcare costs. The authors note that the rate of falls in the United Kingdom and the United States’ surgical and acute medical units is approximately 3.4 and 4.8 per 1000 bed days.  These falls cause physical harm to those affected, including head injuries and hip fractures.  However, de Jong et al. (2020) notes that falls are preventable through universal fall precautions and managing the patients’ risk factors for falls. The author argues that implementing delirium interventions and patient-based education strategies can reduce falls. Nonetheless, evidence regarding multifactorial or specific individual interventions to reduce falls in healthcare settings is limited. 

Multiple factors contribute to fall prevalence in the hospital setting. According to de Jong et al. (2020), most falls in the healthcare setting result from unsupervised patients, especially those diagnosed with cognitive impairment or dementia. These patients do not understand their mobility needs, requiring healthcare providers to assist them.  However, some healthcare facilities use patient sitters to minimize falls among unsupervised patients. The strategy is effective because it offers patients companionship and continuous observation to reduce their falling risk. Nonetheless, de Jong et al. (2020) note that there lacks evidence regarding patient sitter’s effectiveness in fall reduction. Some research suggests that patient sitters might be expensive or ineffective because their use may result in increased falls. Therefore, further research is required to understand patient sitter effectiveness in reducing falls.

de Jong et al.(2020) note that  if healthcare providers use patient sitters as a fall prevention intervention, they should assess whether they have the skills and  background knowledge to prevent patient falls. Previous studies have suggested a lack of clear guidelines regarding the sitter’s role, and their approach to care remains inconsistent. Therefore, the sitter’s education, training, and motivation are paramount to enhancing their competence in preventing falls. Limited research exists regarding sitter’s readiness to prevent falls among hospitalized patients. The existing study’s findings indicate that sitters lack competence in caring for dementia patients. Additionally, they lack awareness and knowledge of fall prevention strategies. According to de Jong et al. (2020), the theory of health behavior change mandates that individuals should have the knowledge, skills, motivation, and opportunity to engage in beneficial health behaviors. Therefore, healthcare providers should prepare sitters before engaging them in a falls prevention program. In this context, if the sitters’ motivation, opportunity, knowledge, and skills are inadequate, they increase the patient’s risk of falling. Thus, de Jong et al. (2020) purpose was to analyze hospital patient sitters’ motivation, opportunity, and capability to implement fall prevention strategies.

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Describing the Research Methodology

de Jong et al.(2020) used a cross-sectional survey  to conduct their study. The researchers’ pilot tested the survey before using it to collect information. de Jong et al.(2020) also evaluated the deductive analytic framework  before conducting the cross-sectional survey. The surveyor asked clinical ward managers if their wards had patient sitters. Patient sitters who agreed to participate in the study were checked to ensure they met the inclusion criteria. The patient sitters filled the survey as the surveyor observed their patients to enhance their safety and allow the study participants to respond to the survey questions without worry. The questionnaire included questions about the patient sitter’s training needs, background, and motivation. The survey incorporated open-ended, categorical, and multi-choice responses.