Implementation strategies to support fall prevention interventions in long-term care facilities for older persons: a systematic review

BMC Geriatrics

Research

Suzanne Timmons¹  Lauren O’Mahony¹  Neah Albasha²  Leanne Ahern³  Ruth McCullagh³  Nicola Cornally⁴  Sheena McHugh⁵ 

[1] Center for Gerontology and Rehabilitation, School of Medicine, University College Cork, St Finbarr’s Hospital, The Bungalow, Block 13, Douglas Road, Cork City, Ireland;Center for Gerontology and Rehabilitation, School of Medicine, University College Cork, St Finbarr’s Hospital, The Bungalow, Block 13, Douglas Road, Cork City, Ireland;Rehabilitation Department, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia;School of Clinical Therapies, University College Cork, Cork City, Ireland;School of Nursing and Midwifery, University College Cork, Cork City, Ireland;School of Public Health, University College Cork, Cork City, Ireland;

关键词: Falls prevention;    Older person;    Long-term care;    Residential care;    Implementation;    Feasibility;   

DOI  :  10.1186/s12877-023-03738-z

 received in 2022-06-28, accepted in 2023-01-09,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundFalls are common among older people in long-term care facilities (LTCFs). Falls cause considerable morbidity, mortality and reduced quality of life. Of numerous interventional studies of fall prevention interventions in LTCFs, some reduced falls. However, there are challenges to implementing these interventions in real-world (non-trial) clinical practice, and the implementation techniques may be crucial to successful translation. This systematic review thus aimed to synthesise the evidence on implementation strategies, implementation outcomes and clinical outcomes included in fall prevention intervention studies.MethodsA systematic search of six electronic databases (PubMed, CINAHL, EMBASE, PsycINFO, SCOPUS, Web of Science) and eight grey literature databases was conducted, involving papers published during 2001–2021, in English or Arabic, targeting original empirical studies of fall prevention interventions (experimental and quasi-experimental). Two seminal implementation frameworks guided the categorisation of implementation strategies and outcomes: the Expert Recommendations for Implementing Change (ERIC) Taxonomy and the Implementation Outcomes Framework. Four ERIC sub-categories and three additional implementation strategies were created to clarify overlapping definitions and reflect the implementation approach. Two independent researchers completed title/abstract and full-text screening, quality appraisal assessment, data abstraction and coding of the implementation strategies and outcomes. A narrative synthesis was performed to analyse results.ResultsFour thousand three hundred ninety-seven potential papers were identified; 31 papers were included, describing 27 different fall prevention studies. These studies used 39 implementation strategies (3–17 per study). Educational and training strategies were used in almost all (n = 26), followed by evaluative strategies (n = 20) and developing stakeholders’ interrelationships (n = 20). Within educational and training strategies, education outreach/meetings (n = 17), distributing educational materials (n = 17) and developing educational materials (n = 13) were the most common, with 36 strategies coded to the ERIC taxonomy. Three strategies were added to allow coding of once-off training, dynamic education and ongoing medical consultation. Among the 15 studies reporting implementation outcomes, fidelity was the most common (n = 8).ConclusionThis is the first study to comprehensively identify the implementation strategies used in falls prevention interventions in LTCFs. Education is the most common implementation strategy used in this setting. This review highlighted that there was poor reporting of the implementation strategies, limited assessment of implementation outcomes, and there was no discernible pattern of implementation strategies used in effective interventions, which should be improved and clearly defined.Trial registrationThis systematic review was registered on the PROSPERO database; registration number: CRD42021239604.

【 授权许可】

CC BY   
© The Author(s) 2023

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