Outcomes from the Implementation of a Facility-Specific Evidence-Based Falls Prevention Intervention Program in Residential Aged Care

Nitz, Jennifer C.; Cyarto, Elizabeth; Andrews, Sharon; Fearn, Marcia; Fu, S.; Haines, Terrence Peter; Haralambous, Betty; Hill, Keith; Hunt, Susan; Lea, Emma; Moore, Kirsten; Renehan, Emma; Robinson, Andrew

doi:10.1016/j.gerinurse.2011.11.002

Cited by 28 publications

(44 citation statements)

References 19 publications

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“…An example is the incorrect use of walking aids associated with falls (6) , caused by their inadequacy to the type of gait of the elderly or by damage to the instruments. Tripping over the walking aids of other residents is often described as a cause of falls during walking (1) . Regarding action, the practices and behaviors of the elderly (15) as well as the professionals must be monitored, improved, and evaluated.…”

Section: Discussionmentioning

confidence: 99%

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Falls in long-term care institutions for elderly people: protocol validation

2017

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Objectives: To validate the content of a fall management risk protocol in long-term institutions for elderly people. Methods: Methodological, quanti-qualitative study using the Delphi technique. The tool, based on the literature, was sent electronically to obtain consensus among the 14 experts that meet the defi ned inclusion criteria. Results: The 27 indicators of the protocol are organized in three dimensions: prepare for the institutionalization (IRA=.88); manage the risk of falls throughout the institutionalization (IRA=.9); and lead the communication and formation (IRA=1), with a CVI=.91. Two rounds were performed to get a consensus superior to 80% in every item. Conclusion: The values obtained in the reliability test (>0.8) show that the protocol can be used to meet the intended goal. The next step is the clinic validation of the protocol with residents of long-term care institutions for elderly people. Descriptors: Accidental Falls; Aged; Accident Prevention; Nursing; Institutionalization. RESUMO Objetivos: Validar o conteúdo de um protocolo para a gestão do risco de queda em Instituições de Longa Permanência para Idosos. Método: Estudo metodológico, de abordagem quantiqualitativa, utilizando a técnica de Delphi. O instrumento, construído com base na literatura, foi enviado por via electrónica, para obter consenso entre os 14 peritos que respeitam os critérios de inclusão defi nidos. Resultados: Os 27 indicadores do protocolo estão organizados em três dimensões: Preparar a Institucionalização (IRA=,88); Gerir o Risco de Queda ao longo da Institucionalização (IRA=,9) e Liderar a comunicação e formação (IRA=1), com um CVI=,91. Foram efetuadas duas rodadas para se obter consenso superior a 80% em todos os itens. Conclusão: Os valores obtidos no teste de fi dedignidade (>0,8) atestam que o protocolo pode ser utilizado para atingir o fi m que se pretende. A próxima etapa é a validação clínica do protocolo com idosos residentes em Instituições de Longa Permanência para Idosos. Descritores: Acidentes por Quedas; Idosos; Prevenção de Acidentes; Enfermagem; Institucionalização. RESUMEN Objetivos: Validar el contenido de un protocolo para gestión de riesgo de caídas en Residencias Geriátricas. Método: Estudio metodológico, de abordaje cualicuantitativo, utilizando técnica de Delphi. El instrumento elaborado con base en la literatura fue enviado por vía electrónica para obtener consenso entre los 14 peritos que observan los criterios de inclusión defi nidos. Resultados: Los 27 indicadores del protocolo están organizados en tres dimensiones: Preparar la Institucionalización (IRA=,88); Gerenciar el Riesgo de Caída durante la institucionalización (IRA=,9); y Liderar la comunicación y formación (IRA=1), con un CVI=,91. Fueron efectuadas dos rondas para obtener consenso superior al 80% en todos los ítems. Conclusión: Los valores obtenidos en el test de fi delidad (>0,8) certifi can que el protocolo puede utilizarse para alcanzar el fi n pretendido. La siguiente etapa será la validación clínica del protocolo con ...

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Section: Discussionmentioning

confidence: 99%

“…Falls are a recurrent problem for older people and a matter of concern in long-term care (LTC) institutions for the elderly (1)(2)(3) , where their incidence varies between 34% and 67% (4) . They are a common cause of institutionalization and affect the independent residents of LTC facilities (5) .…”

Section: Introductionmentioning

confidence: 99%

Falls in long-term care institutions for elderly people: protocol validation

2017

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“…3 With estimated incidence of 32.5% to 68% in long-term care (LTC) institutions, falls are an issue for institutionalized elderly people, who show significantly higher incidence of the problem than the elderly people living in communities. [4][5] This may be explained by higher levels of dependency and higher incidence of chronic conditions in the institutionalized population. 3,6 The cumulative effect of fearing the falls themselves, post-fall syndrome, and secondary injuries poses a potential risk of epidemy and increased health resource costs in a society with an exponential increase of the elderly population.…”

Section: Introductionmentioning

confidence: 99%

Práticas Das Equipas Na Prevenção De Queda Nos Idosos Institucionalizados: Construção E Validação De Escala

Baixinho

Dixe

2017

Texto contexto - enferm.

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Objective: determine and elaborate the psychometric characteristics of nursing team practices and develop a behavior scale for fall risk management in institutionalized elderly people.Method: the scale was designed based on a literature review and observation of the work of the teams in a long-term care institution for the elderly. The content of the scale was analyzed and the concordance index of the 14 initial items was checked by nine experts. The scale was applied to a sample of 152 caregivers from six long-term care institutions for the elderly. The research conformed to ethical principles. The anonymity of the participants and the confidentiality of the data were ensured.Results: after the determination of the psychometric characteristics, it was observed that the unidimensional scale had six items, with a Cronbach's alpha of 0.918 and a score ranging from 6 to 30 points. Analysis of the results revealed that information about risk factors and team discussions regarding preventive measures are not always present, allowing specific team members to value different measures, which impairs continuity of the care and individualization of the measures before the assessed risk.Conclusion: the scale shows suitable psychometric features and can be used in investigation and clinical practice to assess the practices and behaviors of nursing teams in fall risk management in institutionalized elderly patients. DESCRIPTORS:Falls. Elderly people. Caregivers. Risk management. Psychometry. Behavioral assessment scale. PRÁTICAS DAS EQUIPAS NA PREVENÇÃO DE QUEDA NOS IDOSOS INSTITUCIONALIZADOS: CONSTRUÇÃO E VALIDAÇÃO DE ESCALA RESUMOObjetivo: construir e determinar as características psicométricas da escala de práticas e comportamentos das equipes na gestão do risco de queda dos idosos institucionalizados.Método: a escala foi desenhada com base na revisão da literatura e na observação do trabalho das equipes numa instituição de longa permanência para idosos. Foi realizada a análise de conteúdo e a verificação do índice de concordância dos 14 itens iniciais por nove juízes. A escala foi aplicada a uma amostra de 152 cuidadores de seis instituições de longa permanência para idosos. A investigação respeitou os princípios éticos. Garantiu-se o anonimato e a confidencialidade dos dados.Resultados: após a determinação das caraterísticas psicométricas, verificámos que a escala, unidimensional, ficou constituída por seis itens, com um Alfa de Cronbach de 0,918, pontua entre 6 e 30 pontos. A análise dos resultados permite constatar que a informação sobre os fatores de risco e a discussão em equipe sobre as medidas preventivas nem sempre são mantidas, possibilitando que elementos diferentes da equipe possam valorizar medidas diferentes, o que não garante a continuidade de cuidados e a individualização das medidas face ao risco avaliado.Conclusão: a escala tem boas características psicométricas, podendo ser usada na investigação e na prática clínica para avaliar as práticas e os comportamentos das equipes na gestão do risco de q...

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“…Our study involved RAC staff in the audit process unlike a similar project conducted in RAC facilities that used external project officers as auditors. 21 Involving workplace staff in quality improvement initiatives, such as clinical auditing, has been shown to be more successful than using external experts 10, 13 as they will be the ones responsible for translating evidence into practice. The CoP was instrumental in contributing to the success of the A&F process as CoP members were RAC site staff with existing peer relationships.…”

Section: Discussionmentioning

confidence: 99%

“…Facilitators to CoP actions centred on access to external experts which suggests that research institutions should permanently align themselves with RAC organisations and take a more active role in the translation of evidence into practice. 21,26 A key strength of this study was the inclusion of staff at all 13 sites, led by the CoP, in conducting the audit as opposed to an external agency. The characteristics of a CoP include membership through shared practice across organisational boundaries, with a common topic of focus.…”

Section: Discussionmentioning

confidence: 99%

Using a community of practice to evaluate falls prevention activity in a residential aged care organisation: a clinical audit

Francis‐Coad

Etherton‐Beer

Bulsara

et al. 2017

Aust. Health Review

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Objective This study evaluates whether a community of practice (CoP) could conduct a falls prevention clinical audit and identify gaps in falls prevention practice requiring action. Methods Cross-sectional falls prevention clinical audits were conducted in 13 residential aged care (RAC) sites of a not-for-profit organisation providing care to a total of 779 residents. The audits were led by an operationalised CoP assisted by site clinical staff. A CoP is a group of people with a shared interest who get together to innovate for change. The CoP was made up of self-nominated staff representing all RAC sites and comprised of staff from various disciplines with a shared interest in falls prevention. Results All 13 (100%) sites completed the audit. CoP conduct of the audit met identified criteria for an effective clinical audit. The priorities for improvement were identified as increasing the proportion of residents receiving vitamin D supplementation (mean 41.5%, s.d. 23.7) and development of mandatory falls prevention education for staff and a falls prevention policy, as neither was in place at any site. CoP actions undertaken included a letter to visiting GPs requesting support for vitamin D prescription, surveys of care staff and residents to inform falls education development, defining falls and writing a falls prevention policy. Conclusion A CoP was able to effectively conduct an evidence-based falls prevention activity audit and identify gaps in practice. CoP members were well positioned, as site staff, to overcome barriers and facilitate action in falls prevention practice. What is known about the topic? Audit and feedback is an effective way of measuring clinical quality and safety. CoPs have been established in healthcare using workplace staff to address clinical problems but little is known about their ability to audit and influence practice change. What does this paper add? This study contributes to the body of knowledge on CoPs in healthcare by evaluating the performance of one in the domain of falls prevention audit action. What are the implications for practitioners? A CoP is an effective model to engage staff in the clinical audit process. Clinical audits can raise staff awareness of gaps in practice and motivate staff to plan and action change as recommended in best practice guidelines.

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Outcomes from the Implementation of a Facility-Specific Evidence-Based Falls Prevention Intervention Program in Residential Aged Care

Cited by 28 publications

References 19 publications

Falls in long-term care institutions for elderly people: protocol validation

Falls in long-term care institutions for elderly people: protocol validation

Práticas Das Equipas Na Prevenção De Queda Nos Idosos Institucionalizados: Construção E Validação De Escala

Using a community of practice to evaluate falls prevention activity in a residential aged care organisation: a clinical audit

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