Evaluation of a patient and clinician education program for falls prevention in hospitals

The study design will incorporate a mixed-methods approach. This will allow for both quantitative and qualitative methods to be utilised, enabling a more holistic understanding of the impact of the intervention. This study will utilise a convergent explanatory design with two arms: one arm is focused on patient education, while the other arm is focused on clinician training. Patient Education Traditionally, patients often receive falls education in a myriad of ways. These include receiving a falls prevention brochure, attending a falls prevention education group, receiving falls prevention education during therapy sessions with allied health staff, or through informal conversations with nurses. This is not usually consistent between every patient or health professional. Thus, this education intervention incorporates interprofessional collaboration to empower patients in managing their safety in hospital. The patient education intervention (which is named EMPOWER) will include the standardised Healthscope falls prevention brochure plus a face-to-face semi-scripted conversation focused on clarifying the information, utilising teach-back methods and encouraging goal setting. Ward staff will be trained to share information and collaborate between professions to deliver the intervention effectively. Interprofessional communication about the patient education processes will ensure each patient on the ward receives the education. This can take place informally or through handovers via daily ‘huddles’. These ‘huddles’ are formal handover sessions between nurses-in-charge and the allied health team which are carried out at all hospital sites. They often occur in the morning and are an effective way to communicate health changes or updates relating to individual patients between health disciplines. The semi-scripted conversation is based on the principles of the Safe Recovery Program (SRP). The 12 steps of the original SRP has been condensed into 3 steps: (i) identifying the ‘leverage point’ and linking back to falls prevention; (ii) setting a goal; and (iii) follow up. With these steps, this intervention aims to empower patients to take onus of their own falls prevention, while still being feasible for ward staff to carry out. The approximate duration of this intervention is 10 minutes. This will be a ward-based intervention carried out collaboratively by allied health staff and nurses over 4 weeks. It is intended to be stand alone and separate to the admission process. Either nurses or allied health professionals will deliver this intervention within 24 hours of admission of the patient. Interactions between nurses and allied health professionals will occur following the intervention highlighting key issues for clinical handover and to ensure messaging is being reinforced. Based on interprofessional communications and delegations of responsibility, follow up conversations will be held by nurses or allied health professionals in the following 2-3 days. Once the initial education has been delivered, a paper labelled “EMPOWER” will be placed on the front of the patient’s bedside chart/file. This will serve as a reminder to staff that the education has already been delivered and follow up will be required. Clinical staff are given access to a laminated guide to the script which they can refer to during the conversation. The placement of an EMPOWER sign in the front pocket of a patient’s bedside chart will indicate if the intervention has been carried out. Clinician Training Eligible ward staff include all those involved in the care of the patients, including registered nurses, enrolled nurses, physiotherapists, occupational therapists and allied health assistants. Participants will receive a 1-hour high-quality education program using best educational design. This will educate clinicians on the latest evidence on patient education for falls prevention and support effective implementation of the patient education intervention, including the processes to achieve effective interprofessional collaborative practice. A blended approach will be used to deliver the education program. The education intervention will be multifaceted and will utilise a mixture of interactive teaching methods suited to the learning needs of busy clinicians. Methods of educational delivery will include: • Small group discussion on what the clinicians’ current falls prevention education to patients entails • Small group critical thinking activity on the barriers and facilitators to clinicians delivering falls prevention education to patients • Content delivery on the latest evidence on patient education and its role in falls prevention in hospitals • Use of three recorded vignettes using simulated participants to demonstrate the delivery of falls prevention education to patients using a standardised Healthscope falls prevention brochure. The vignettes will include face-to-face semi-scripted conversations focused on clarifying the information, utilising teach-back methods and encouraging goal setting. Clinician training will be provided by a Physiotherapy Research Fellow or a Nursing Professor. A session attendance checklist will be used to monitor adherence to complete the PICF, survey 1 and survey 2. A list of clinicians eligible for training will be provided by the Nurse Unit Manager on the ward. Additional resources (Panopto recording and PowerPoint presentations) will be provided for those staff not able to attend the training and to supplement the learning for staff who attended.