Formulate a clinical problem that is nursing sensitive and patient focused. Develop a PICO statement to articulate a research question>

Research evidence can be combined to create best practices for improving patient care.


One of your most significant tasks as a nurse is to give the best possible patient care. To achieve this objective, evidence-based practice (EBP), must be incorporated into the clinical model. Iowa Model for Evidence-Based Practice can help you guide EBP implementation. The paper I am presenting will outline the path to clinical changes that I want in my current practice. What I’m going to focus on is the reduction of patient falls within the hospital environment.

Step 1: Create a clinical problem

One of the clinical problems I want to fix is the high number of falls that occur in hospitals. Falls pose a serious problem to patients and hospitals. Falls can lead to injuries or emotional trauma and long hospital stays. For this type of clinical issue, the PICO statement is:

Population: Hospitalized patients

Intervention: Application of a fall prevention program

Comparison: A comparison of fall incidence before and after the fall prevention protocol was implemented

The outcome: A reduction in falls

Time: Six months

Step 2: Establish an Organizational Commitment

To implement the fall prevention protocol, it is essential to have the commitment of the hospital’s administration and staff. It is essential that the hospital’s administration commit to providing all resources needed to help implement the fall prevention protocols. Nursing staff should be dedicated to providing best care for patients, and to the implementation of the fall prevention protocol.

Step 3: Form a team to gather and evaluate evidence

It is essential that the fall prevention protocol succeeds by forming a team of experts to collect and assess evidence. This team must include nurses, doctors, physical therapists and occupational therapists as well as other healthcare professionals. They should collaborate to collect evidence about fall prevention and appraise it, before developing a fall prevention protocol.

Step 4: Assess if there is sufficient evidence to implement the clinical change

It is up to the team to determine whether there are sufficient evidence for the adoption of the fall prevention protocol. Review the literature and find best practices in fall prevention. The team should also review the hospital’s current fall prevention practices and assess their effectiveness.

Step 5: Test feasibility with a pilot modification

To test its feasibility, it is necessary to implement a pilot program before the hospital can adopt the fall prevention protocol. Pilot changes should only be made on a very small scale and should be evaluated. Based on the evaluation, the pilot change should then be altered.

Step 6: Assess the Plan/Change

The fall prevention protocols should be evaluated on an ongoing basis. Monitoring falls should be done by the nurses and reporting any incidents. Each member of the team should periodically review the fall prevention protocol and recommend any necessary modifications.

Step 7: Distribute the Results

Hospital staff and patients should receive the results of the fall prevention protocol. Results should be presented to hospital conferences, published in medical journals and shared with all hospitals.


Iowa Model for Evidence-Based Practice is a method for implementing clinical improvements that are supported by research. The seven steps in the Iowa Model for Evidence-Based Practice can be used by healthcare professionals to make sure that their changes are evidence-based and patient-focused. Implementing the fall prevention protocol can reduce falls within the hospital and increase patient outcomes.


  1. Oliver, D., Healey, F., & Haines, T. P. (2010). Hospital fall prevention and injury prevention. Clinics in geriatric medicine, 26(4), 645-

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