Falls assessment and interventions among older patients in two medical and one surgical hospital wards in Spain: a best practice implementation project

Albornos-Muñoz, Laura; Melián-Correa, Esther; Acosta-Arrocha, Amanda; Gallo-Blanco, Carmen; Béjar-Bacas, Felicidad; Alonso-Poncelas, Emma; Serra-Estrada, Montserrat; González‐María, Esther; Moreno‐Casbas, María Teresa

doi:10.11124/jbisrir-2017-003349

Cited by 6 publications

(41 citation statements)

References 12 publications

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“…Champions are those healthcare professionals who are committed to implementing change, act as a role model for the intended change and are enthusiastic in convincing others in the organisation of the necessity of change [69,82,86,89,101,103,109]. Two kinds of champions were identified, those that initiated an audit [36,49,54,59,69,74,82,89] and those nominated by the leadership of an organisation and given responsibility for carrying the audit forward [43,47,53,57,85,86,90,91,95,101,103,104,109,119]. In successful audits champions challenge, educate and lead their colleagues to improve the quality of care [69,90,91,95,101,119].…”

Section: Plos Onementioning

confidence: 99%

“…This encouraged a more critical attitude and attention to the quality of the care they delivered, increases their commitment to QI [36,69,82,89], and lead to changes intended to improve care being successfully implemented [36,53,57,59]. A supportive organisational culture is an important contextual factor for champions to be able to perform [36,54,69,86,89,90,103]. In bottom-up initiated audits, healthcare professionals take the lead.…”

Section: Plos Onementioning

confidence: 99%

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Understanding how and why audits work in improving the quality of hospital care: A systematic realist review

et al. 2021

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Background Several types of audits have been used to promote quality improvement (QI) in hospital care. However, in-depth studies into the mechanisms responsible for the effectiveness of audits in a given context is scarce. We sought to understand the mechanisms and contextual factors that determine why audits might, or might not, lead to improved quality of hospital care. Methods A realist review was conducted to systematically search and synthesise the literature on audits. Data from individual papers were synthesised by coding, iteratively testing and supplementing initial programme theories, and refining these theories into a set of context–mechanism–outcome configurations (CMOcs). Results From our synthesis of 85 papers, seven CMOcs were identified that explain how audits work: (1) externally initiated audits create QI awareness although their impact on improvement diminishes over time; (2) a sense of urgency felt by healthcare professionals triggers engagement with an audit; (3) champions are vital for an audit to be perceived by healthcare professionals as worth the effort; (4) bottom-up initiated audits are more likely to bring about sustained change; (5) knowledge-sharing within externally mandated audits triggers participation by healthcare professionals; (6) audit data support healthcare professionals in raising issues in their dialogues with those in leadership positions; and (7) audits legitimise the provision of feedback to colleagues, which flattens the perceived hierarchy and encourages constructive collaboration. Conclusions This realist review has identified seven CMOcs that should be taken into account when seeking to optimise the design and usage of audits. These CMOcs can provide policy makers and practice leaders with an adequate conceptual grounding to design contextually sensitive audits in diverse settings and advance the audit research agenda for various contexts. PROSPERO registration CRD42016039882.

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Section: Plos Onementioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

Understanding how and why audits work in improving the quality of hospital care: A systematic realist review

et al. 2021

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“…Con este proyecto se ha evaluado la efectividad de un modelo de implantación (Getting Research into Practice-GRIP) de recomendaciones basadas en la evidencia. Este modelo ha sido utilizado en otros estudios, pero con un número de unidades más reducido (Albornos-Muñoz et al, 2018;Ang et al, 2011;Comino-Sanz et al, 2018;Daniels, 2016;De Oliveira Motta Maia et al, 2018;Johnston et al, 2011;Martın-Losada et al, 2019;Roos-Blom et al, 2019;Stevens et al, 2014;Szymaniak, 2015;Tíscar-González et al, 2019;Trad et al, 2019).…”

Section: Discussionunclassified

“…Si nos centramos en estudios realizados con el mismo modelo (Albornos-Muñoz et al, 2018;Comino-Sanz et al, 2018;De Oliveira Motta Maia et al, 2018;Szymaniak, 2015), se identifican frecuencias basales de valoración del riesgo y del riesgo tras una caída de 28-29-71% ( 3 unidades que valoran riesgo de caídas) y 7,7% (tras una caída) en Albornos et al; 52% (riesgo de caídas) en Comino et al; 64% (riesgo de caídas) y 39% (tras una caída) en De Oliveira et al y un 92% (riesgo de caída) y un 87% (tras un caída) en el de Szymaniak (2015). Llegando a niveles finales de adherencia con un incremento entre el 8 y el 34% en el riesgo de caídas y de -1 a 39% en la valoración tras una caída (con un descenso leve en la valoración del riesgo tras una caída en el estudio de Szymaniak).…”

Section: Indicadores Relacionados Con La Valoración Y Manejo Del Ries...unclassified

“…La mayoría de estudios parten de cifras basales cercanas al nuestro (Johnson et al, 2015;Oliveira Crossetti & Oliveira de Góes, 2017;Szymaniak, 2015), excepto Comino et al (2018) y Albornos et al (2018, que parten de basales cercanos al 100% en algunas unidades. En cuanto a los niveles finales de adherencia nuestro estudio alcanza los valores finales más altos y en algunos estudios indican un descenso en el cumplimiento de este indicador (Albornos-Muñoz et al, 2018;Comino-Sanz et al, 2018).…”

Section: Indicadores Relacionados Con La Valoración Y Manejo Del Ries...unclassified

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Efectividad de un modelo de implantación de evidencia en la práctica clínica y análisis de redes sociales de transferencia del conocimiento en profesionales de Enfermería = Effectiveness of an evidence-based implementation model in clinical practice and analysis of social networks of knowledge transfer in nursing professionals

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Health technologies for the prevention and detection of falls in adult hospital inpatients: a scoping review

Cooper

Pavlova

Greig

et al. 2021

JBI Evidence Synthesis

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Objective: The objective of this scoping review was to examine and map the evidence relating to the reporting and evaluation of technologies for the prevention and detection of falls in adult hospital inpatients.Introduction: Falls are a common cause of accidental injury, leading to a significant safety issue in hospitals globally, and resulting in substantial human and economic costs. Previous research has focused on community settings with less emphasis on hospital settings to date. Inclusion criteria: Participants included adult inpatients, aged 18 years and over; Concept included the use of fall prevention or detection technologies; Context included any hospital ward setting. Methods: This scoping review was conducted according to Joanna Briggs Institute (JBI) methodology for scoping reviews, guided by an a-priori protocol. A wide selection of databases including Medline, CINAHL, AMED, EmBASE, PEDro, Epistimonikos, and Science Direct were searched for records from inception to October 2019. Other sources included grey literature, trial registers, government health department websites and websites of professional bodies. Only studies in the English language were included. A three-step search strategy was employed with all records exported for subsequent title and abstract screening, prior to full text screening. Screening was performed by two independent reviewers and data extraction by one reviewer following agreement checks. Data is presented in narrative and tabular form.Results: Over 13,000 records were identified with 404 included in the scoping review: 336 reported on fall prevention technologies, 51 targeted detection and 17 concerned both. The largest contributions of studies came from the USA (n=185), Australia (n=65), UK (n=36) and Canada (n=18).There was a variety of study designs including 77 prospective cohort studies, 33 before-after studies and a large number of systematic reviews (n=35). However, relatively few randomised controlled trials were conducted (n=25). The majority of records reported on multifactorial and multicomponent technologies (n=178), followed by fall detection devices (n=86). Few studies reported on the following interventions in isolation: fall risk assessment (n=6), environment design (n=8), sitters (n=5), rounding (n=3), exercise (n=3), medical/pharmaceutical (n=2), physiotherapy (n=1) and nutritional (n=1). The majority (56%) of studies reported clinical effectiveness outcomes with smaller numbers (14%) reporting feasibility and/or acceptability outcomes, or cost-effectiveness outcomes (5%). Conclusions:This review has mapped the literature on falls prevention and detection technology and outcomes for adults in the hospital setting. Despite the volume of available literature, there remains a need for further high-quality research on fall prevention and detection technologies.

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Falls assessment and interventions among older patients in two medical and one surgical hospital wards in Spain: a best practice implementation project

Abstract: The current project may improve compliance with regard to promoting evidence-based fall prevention and management interventions. Further audits are necessary to evaluate any improvements achieved, in particular, care plans.

Cited by 6 publications

References 12 publications

Understanding how and why audits work in improving the quality of hospital care: A systematic realist review

Understanding how and why audits work in improving the quality of hospital care: A systematic realist review

Health technologies for the prevention and detection of falls in adult hospital inpatients: a scoping review

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