The Real World Journey of Implementing Fall Prevention Best Practices in Three Acute Care Hospitals: A Case Study

Abstract

Four recommendations with potential to guide others in fall prevention were identified: (1) the need to listen to and recognize the expertise and clinical realities of staff, (2) the importance of keeping the implementation process simple, (3) the need to recognize that what seems simple becomes complex when meeting individual patient needs, and (4) the need to view the process as one of continuous quality improvement.

The complexity in the implementation process of empowerment-based chronic kidney care: a case study

“…The findings showed that the nurses and assistant nurses of the project group felt they were working together to implement empowerment in healthcare encounters with persons with CKD and their family members. This result is in line with previous research findings, whereby including healthcare professionals in the improvement intervention from the beginning increases their engagement [28]. The participants described their negative experiences in earlier interventions as lack of support and follow-up from leadership.…”

“…Initially, the transcribed data were imported into the qualitative data-analysis software NVIVO 8® (QRS International) [27], which was used to handle the multiple sources of data obtained throughout the whole analysis [28]. Data analysis was performed in several steps.…”

The Nurse as Bricoleur in Falls Prevention: Learning from a Case Study of the Implementation of Fall Prevention Best Practices

“…This paper discusses the concept of nurse as bricoleur in the context of the foundational research study, building on two previous publications (Boblin, Ireland, Kirkpatrick, & Robertson, ; Ireland et al, ). The first publication details the actual research and findings (Ireland et al, ); the second focuses on the use of Qualitative Case Study methodology, Stake's () constructivist approach in particular (Boblin et al., ). The three participating hospitals were Registered Nurses’ Association of Ontario (RNAO) Best Practice Spotlight Organization (BPSO) candidates who had committed to implementing the Falls BPG.…”

“…Our study findings echoed other research in recognizing the complexities inherent in implementation of fall prevention in “real‐life” clinical practice (Oliver et al., ; Rush et al., ; Stenberg & Wann‐Hansson, ). We concluded that Falls BPG implementation was a diverse and complex activity, ideally suited for the involvement of nurse bricoleurs in a variety of organizational and point‐of‐care roles, who acted as facilitators in the multifaceted process of changing practice in fall prevention (Ireland et al, ). Although this discussion paper focuses primarily on nurses at the point‐of‐care, reference is made to nursing leaders in their facilitative roles in fall prevention.…”

“…The ideas presented in this discussion paper originated during a qualitative case study conducted by the authors within three acute care hospitals in Southern Ontario, Canada (Ireland, Kirkpatrick, Boblin, & Robertson, ). This foundational research examined the implementation of the Best Practice Guideline Prevention of Falls and Fall Injuries in the Older Adult (Falls BPG) published by the Registered Nurses Association of Ontario (RNAO, , revised 2011).…”