Implementation fidelity of a multifactorial in-hospital fall prevention program and its association with unit systems factors: a single center, cross-sectional study

BMC Health Services Research

Research

Constantin Sluka¹  Mieke Deschodt²  Flaka Siqeca³  Regula Wyss-Hänecke⁴  René Schwendimann⁵  Susanne Knüppel Lauener⁶ 

[1] Department of Clinical Research, University of Basel and University Hospital of Basel, Spitalstrasse 8/12, 4031, Basel, Switzerland;Department of Public Health and Primary Care, Gerontology and Geriatrics, KU Leuven, Herestraat 49, 3000, Leuven, Belgium;Competence Center of Nursing, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium;Institute of Nursing Science, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland;Institute of Nursing Science, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland;MediZentrum Burgergut, Bernstrasse 107, 3613, Steffisburg, Switzerland;Institute of Nursing Science, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland;Medizinische Direktion, University Hospital of Basel, Hebelstrasse 2, 4031, Basel, Switzerland;Medizinische Direktion, University Hospital of Basel, Hebelstrasse 2, 4031, Basel, Switzerland;

关键词: Accidental falls;    Preventive health services;    Patient safety;    Implementation science;    Routinely collected health data;    Fall prevention program;    Implementation outcomes;   

DOI  :  10.1186/s12913-023-09157-5

 received in 2022-05-30, accepted in 2023-02-06,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundFalls are a common, costly global public health burden. In hospitals, multifactorial fall prevention programs have proved effective in reducing falls’ incidence; however, translating those programs accurately into daily clinical practice remains challenging. This study’s aim was to identify ward-level system factors associated with implementation fidelity to a multifactorial fall prevention program (StuPA) targeting hospitalized adult patients in an acute care setting.MethodsThis retrospective cross-sectional study used administrative data on 11,827 patients admitted between July and December 2019 to 19 acute care wards at the University Hospital Basel, Switzerland, as well as data on the StuPA implementation evaluation survey conducted in April 2019. Data were analysed using descriptive statistics, Pearson’s coefficients and linear regression modelling for variables of interest.ResultsThe patient sample had an average age of 68 years and a median length of stay of 8.4 (IQR: 2.1) days. The mean care dependency score was 35.4 points (ePA-AC scale: from 10 points (totally dependent) to 40 points (totally independent)); the mean number of transfers per patient -(e.g., change of room, admission, discharge) was 2.6 (range: 2.4– 2.8). Overall, 336 patients (2.8%) experienced at least one fall, resulting in a rate of 5.1 falls per 1’000 patient days. The median inter-ward StuPA implementation fidelity was 80.6% (range: 63.9–91.7%). We found the mean number of inpatient transfers during hospitalisation and the mean ward-level patient care dependency to be statistically significant predictors of StuPA implementation fidelity.ConclusionWards with higher care dependency and patient transfer levels showed higher implementation fidelity to the fall prevention program. Therefore, we assume that patients with the highest fall prevention needs received greater exposure to the program. For the StuPA fall prevention program, our results suggest a need for implementation strategies contextually adapted to the specific characteristics of the target wards and patients.

【 授权许可】

CC BY   
© The Author(s) 2023

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