A significant limitation is several of the studies is the weakness of cross-sectional study design to establish causality and although it is able to show correlation, it is crucial to explore the many reasons that may result in the correlation. For example, in the Lake et al. (2010) study, increase in LPN/NA hours was correlated with increase in fall rates. It would be erroneous to conclude that increase LPN/NA hours caused the increase in fall rates, as the study design is unable to support causality. In this case, it is possible that the numbers are merely showing that in the nursing units were patient fall rates were higher, more staff were put on and lower salary workers such as LPNs and NAs were staffed as opposed to RNs. Another example of study design limitation is in the Cho et al. (2016) study that asked nurses to report how often patients fell. Although the number of patient falls in that study are significantly higher than other studies, the validity of the measure is questionable as related to the inconducive nature of employee survey reporting being unbiased and accurate. Furthermore, although 60 hospitals were selected in the study, the control variables of the bed size, funding, and structural and organizational system of the hospitals were unavailable for …show more content…
Firstly, Lake et al. (2010) study’s evidence suggests that paralleling Magnet hospital organizational and staffing patterns can be beneficial to enhancing patient safety. Secondly, Cho et al. (2016), Everhart et al. (2014), Dunton et al. (2004), and Lake et al. (2010) suggest that increase in nurse patient ratio can be beneficial as well. While there are discrepancies on the nursing units, hospital bed size, and hospital organizational systems, these further support the multivariate nature of patient safety, specifically patient falls, as it relates to patient illness, population, hospital resources, and nursing training. However, thirdly, a universal conclusion that can be applied is the need to implement timely updated evidence-based protocols, as the detriment of being unresponsive to significant data was seen in the Donaldson et al. (2005) study. In the effort to improve patient safety, specifically rate of patient falls as it relates to nursing staff, it is important to implement evidence-based measures on a scale that can produce positive results, in a timeline that will allow health professions to provide most up-to-date practice, and the measure of effectiveness to provide valid evidence that can further the discussion and study of this