None listed
Conditions
Brief summary
The aim of this study is to deliver a new evidence-based education program in hospitals called the Safe Recovery program and to evaluate if it reduces falls and injuries. The study will also measure changes in patient and staff knowledge and motivation about falls prevention and if they are taking actions to reduce falls. Falls education is known to reduce patient falls and injuries in hospital. If effective the program will reduce falls and injuries in the wards that take part in the trial.
Interventions
An individualised patient fall prevention program is provided to eligible patients in the participating wards in addition to usual hospital care, alongside staff training. Patient component including being provided with a brochure or booklet designed specifically for the study and watching a video of either 3 or 8 minutes, tailored for ward and patient availability . Tailoring occurs with pre-post discussion approximately 5 to 10 minutes with patient to identify personally relevant messages and
An individualised patient fall prevention program is provided to eligible patients in the participating wards in addition to usual hospital care, alongside staff training. Patient component including being provided with a brochure or booklet designed specifically for the study and watching a video of either 3 or 8 minutes, tailored for ward and patient availability . Tailoring occurs with pre-post discussion approximately 5 to 10 minutes with patient to identify personally relevant messages and develop brief plan to manage their falls risk. Messages focus on tailored needs including seeking help from staff, using walking aids, discussing toileting needs. Brochure left with patient to review as desired and video reshown as desired. Initial intervention is provided by Allied Health Assistant aiming to provide within 48 hours of admission, supervised by Allied Health staff. Patient knowledge is evaluated by ongoing discussion and by questionnaire pre post sessions. The education is reinforced by ward staff. Ward staff training is led by trained allied health and nursing falls champions. The education program is integrated with existing ward falls prevention management, also coordinated by the ward staff and falls champions. Falls champions and allied health receive initial training programs of between 1 and 4 hours and ward staff receive ongoing short training (approximately 15 to 20 minutes online and/ or on ward according to availability and staff rotations with aims for all staff to recieve at least one session of training. Champions and Allied health assistants receive training in the 2 months prior to commencement. Wards enter the intervention at 5 week periods over the time of the trial (70 weeks) therefore some wards have a longer exposure to the intervention Usual care involves falls risk assessment and treatment provided by ward staff from time of admission and as part of patients medical care and their multidisciplinary care, Hospital wide falls policies and practice and 24 hour care of patients. Staff at all hospitals follow mandated policies and guidelines for falls prevention and post fall care and patients are provided with falls prevention education in patient orientation materials and by staff throughout admission. In intervention wards patients will additionally be seen by the Allied Health Assistant and be provided with the video and booklet and have this education re-inforced by staff will receive specific training that assists them to respond to the patient to help them to meet their actions (e.g. asking for help) that are directed by the messaging.
Sponsors
The University of Western Australia
Study design
Allocation
Randomised controlled trial
Intervention model
Other
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
a) Ward level (effectiveness outcomes) Wards for the trial will be medical, acute care wards, with some rehabilitation or surgical wards and enrol large numbers of older adults. Patients will be screened by their team to be medically stable to receive the patient component of the education. b) Individual level (implementation outcomes) Patients who are receiving care on participating wards and/ or their family will be eligible for inclusion. Patients who do not speak English will be included for consideration for interview if their family are present on the ward. Staff who work on participating wards from the multidisciplinary team.
Exclusion criteria
a) Ward level (effectiveness outcomes) Wards that provide care for children <18 years, ante or post-natal services, intensive care or high dependency units or emergency departments will be excluded from consideration. These wards have a different context for falls events and therefore tailored strategies are required. Surgical units may be included if the patient population includes large numbers of older adults admitted and if the length of stay is greater than 48 hours. Short stay or ambulatory units are not included as they also have differing requirements for falls prevention programs. Any patients who are deemed too unwell, or unable to be approached for other reasons (e.g. infection control, acute confusion) will be excluded by ward staff at the time of patient component of education delivery. However relevant staff interventions, such as noting strategies in the care plan and speaking to families, continue across the wards for all patients, regardless of which patients are personally shown the education. b) Individual level (implementation outcomes) Staff who have not worked on participating wards for at least six weeks will be excluded from participation as they will have limited knowledge and experience of the intervention. Patients who are not able to provide written informed consent, due to having a cognitive impairment diagnosed by the medical team will be excluded. Where patients have diagnosed dementia or acute confusion, their family members will be asked to participate in an interview to seek their reflections on the patient’s experience on the ward.
Outcome results
None listed