Chapter One Outline

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University of Nairobi *

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RESEARCH P

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Nursing

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Nov 24, 2024

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1 Student’s Name Institution Course Instructor Date
2 How Does Increase Nursing Staff Compared to Working Minimum Staffing Prevent Falls of Geriatric Dementia Patients? I. Introduction A. Background of the Problem 1. Prevalence of falls in geriatric dementia patients (Korp, 2023). 2. Impact of falls on health and well-being (Fernando et al., 2017). 3. Financial costs to healthcare (Pedroza et al., 2022) B. Need for Investigation 1. Existing gap in literature (Okeorji, 2017). 2. Relationship between staffing levels and falls (Keise, 2019). II. The Significance of the Study A. Contribution to Nursing 1. Improving quality of care for geriatric dementia patients (Spichiger et al., 2021). 2. Enhancing patient safety (George et al., 2013). B. Significance to Health and Well-being 1. Impact on patient outcomes and quality of life (Marzban et al., 2022). 2. Reducing healthcare costs (Spilsbury et al., 2011). C. Relevance to the U.S. Healthcare System 1. Policy implications 2. Implications for nursing practice (ANA, 2018). III. Problem Statement
3 The problem at hand is the connection between nursing staffing levels and the prevention of falls in geriatric dementia patients. IV. The Purpose of the Study This study aims to investigate the connection between nursing staffing levels and the prevention of falls in geriatric dementia patients. V. Research Questions RQ1: Can an increase in nursing staff compared to working minimum staffing levels effectively prevent falls in geriatric dementia patients? VI. Assumptions of the Study 1. Adequate nursing staffing can reduce the risk of falls in geriatric dementia patients. 2. Nursing staffing levels can be increased without adversely affecting patient care quality. VII. Theoretical Definitions A. Falls Falls are defined as “unintentionally coming to rest on the ground or a lower level, excluding intentional change in position to rest in furniture, wall, or other objects” (CDC, 2020). B. Nursing Staffing Levels Nursing staffing levels refer to “the ratio of registered nurses and nursing assistants to the number of geriatric dementia patients in a healthcare facility" (Fernando et al., 2017). VIII. Operational Definitions A. Falls Prevention Strategy
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4 A falls prevention strategy is defined in this study as “any intervention or practice aimed at reducing the incidence of falls in geriatric dementia patients, such as increased nurse-to-patient ratios or the implementation of fall risk assessments" (Keise, 2019). B. Nursing Staffing Ratio Nursing staffing ratio is operationally defined as “the number of registered nurses and nursing assistants per 10 geriatric dementia patients in a healthcare facility" (Spilsbury et al., 2011).
5 References American Nurses Association (ANA). (2018). Nursing practice and patient safety . Retrieved from https://www.nursingworld.org/practice-policy/nurse-staffing/ Centers for Disease Control and Prevention (CDC). (2020). Falls in nursing homes . Retrieved from https://www.cdc.gov/ncipc/falls/fallenv.htm Centers for Disease Control and Prevention (CDC). (2023, March 23). Health and Economic Costs of Chronic Diseases . CDC. https://www.cdc.gov/chronicdisease/about/costs/index.htm# Centers for Medicare & Medicaid Services (CMS). (2023). Nursing home data compendium . Retrieved from https://www.cms.gov/Medicare/Provider-Enrollment-and- Certification/CertificationandComplianc/downloads/nursinghomedatacompendium_508.p df Fernando, E., Fraser, M., Hendriksen, J., Kim, C. H., & Muir-Hunter, S. W. (2017). Risk factors associated with falls in older adults with dementia: a systematic review. Physiotherapy Canada , 69 (2), 161-170. George, J., Long, S., & Vincent, C. (2013). How can we keep patients with dementia safe in our acute hospitals? A review of challenges and solutions. Journal of the Royal Society of Medicine , 106 (9), 355-361. Keise, K. (2019). Preventing Falls in Long-Term Care Facilities. Walden Dissertations and Doctoral Studies. https://scholarworks.waldenu.edu/cgi/viewcontent.cgi? article=9086&context=dissertations
6 Korp, A. (2023, January 12). Fall Rate Nearly 50% Among Older Americans with Dementia . Drexel News. https://drexel.edu/news/archive/2023/January/Fall-Rate-Nearly-50-Percent- Among-Older-Americans-with-Dementia# Marzban, S., Najafi, M., Agolli, A., & Ashrafi, E. (2022). Impact of Patient Engagement on Healthcare Quality: A Scoping Review. Journal of Patient Experience , 9 , 23743735221125439. Okeorji, A. P. (2017). The impact of nursing staff ratios on falls rates in skilled nursing facilities (Doctoral dissertation, Walden University). Pedroza, P., Miller-Petrie, M. K., Chen, C., Chakrabarti, S., Chapin, A., Hay, S., ... & Dieleman, J. L. (2022). Global and regional spending on dementia care from 2000–2019 and expected future health spending scenarios from 2020–2050: an economic modelling exercise. EClinicalMedicine , 45 . Spichiger, F., Koppitz, A. L., De Wolf‐Linder, S., Murtagh, F. E., Volken, T., & Larkin, P. (2021). Improving caring quality for people with dementia in nursing homes using IPOS‐Dem: A stepped‐wedge cluster randomized controlled trial protocol. Journal of Advanced Nursing , 77 (10), 4234-4245. Spilsbury, K., Hewitt, C., Stirk, L., & Bowman, C. (2011). The relationship between nurse staffing and quality of care in nursing homes: a systematic review. International journal of nursing studies , 48 (6), 732-750.
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