Falls in patients with dementia in the long-term care setting

When conducting a search on the topic of falls in patients with dementia in the long-term care setting, the best resources to use would include databases that focus on healthcare research and evidence-based practice. Some appropriate databases to consider are:

PubMed: This database is a widely used resource for searching biomedical literature, including articles from medical journals. It provides access to a vast collection of research studies, clinical trials, and systematic reviews.

CINAHL (Cumulative Index to Nursing and Allied Health Literature): This database is specifically focused on nursing and allied health subjects, making it a valuable resource for finding articles related to falls in the long-term care setting.

Cochrane Library: The Cochrane Library is a collection of high-quality, independent evidence-based reviews and clinical trials. It provides comprehensive coverage of healthcare interventions and is an excellent resource for finding systematic reviews and meta-analyses related to fall prevention strategies.

In addition to these databases, clinical practice guidelines can also be located through various sources, such as:

National Guideline Clearinghouse: This online resource provides access to evidence-based clinical practice guidelines developed by various professional organizations and government agencies.

Professional nursing organizations: Organizations like the American Nurses Association (ANA) or specialty-specific organizations like the Gerontological Society of America (GSA) may have published guidelines or recommendations related to fall prevention in patients with dementia.

For the search, key terms that could be used include “falls,” “dementia,” “long-term care,” “restraint alternatives,” “fall prevention protocol,” and “comprehensive falls assessment.” These terms capture the main concepts of the PICO question and are broad enough to yield a range of relevant articles.

To narrow down the search results, filters can be applied based on study design, publication date, and language. For example, filtering for recent articles published within the last 5 years can ensure that the information retrieved is up-to-date.

Based on the search results, at least three articles that could be considered for an EBP project are:

Article 1: A systematic review published in a reputable journal that synthesizes evidence from multiple studies on fall prevention strategies in patients with dementia. This article would be considered a Level I source as it provides a comprehensive analysis of existing research.

Article 2: A randomized controlled trial (RCT) comparing the effectiveness of a comprehensive falls assessment prevention plan that includes restraint alternatives with a fall prevention protocol that includes the use of restraints. RCTs are generally considered Level I evidence due to their rigorous study design.

Article 3: A clinical practice guideline developed by a professional organization specializing in geriatric care or dementia. Clinical practice guidelines are valuable resources as they provide evidence-based recommendations for healthcare professionals and are typically based on a synthesis of high-level evidence.

These sources would be most appropriate in determining best practices and supporting clinical decision-making because they provide reliable and robust evidence. Systematic reviews and RCTs are considered the highest level of evidence as they involve rigorous methods for collecting and analyzing data. Clinical practice guidelines, on the other hand, provide evidence-based recommendations that are informed by a synthesis of high-quality research. By utilizing these sources, the interprofessional team can make informed decisions about fall prevention strategies for patients with dementia in the long-term care setting.