Adopting a knowledge translation framework and applying information strategies for fall prevention among hospitalised patients

Article type
Authors
Chen KH1, Liu HE2, Chen TH3, Su HC4, Kuo KN1, Chen CC1
1Cochrane Taiwan, Taipei Medical University
2School of Nursing, Chang Gung University
3Division of Nephrology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University
4Department of Nursing, Wan Fang Hospital, Taipei Medical University
Abstract
Background: Preventing in-hospital fall and associated injury is one of the imperative quality indicators in hospitals. It is also an important challenge for health professionals.

Objectives: The aims of this study were to revise the fall-prevention guidelines for inpatients, as well as to establish "fall prevention nursing decision aids" and "prone to fall medication reminder system" in promoting knowledge translation.

Methods: This is knowledge-translation research based on the "knowledge-to-action conceptual framework" (Graham et al., 2006). There are two stages including: (1) Knowledge creation: We systematically reviewed the existing fall-prevention guidelines to explore the gap between best evidence and clinical practice. Accordingly, the inpatients' fall-prevention guideline of the target hospital was revised. (2) The action cycle: A single centre intervention, before-after study design, was conducted in a medical centre between January and December 2015. The main outcome measures were fall rate (%), fall-related injuries (%), and compliance rate of fall-prevention guidelines among health professionals. For statistic method, we applied Poisson regression model and independent t-test. A p < .05 value is considered statistically significant.

Results: After the intervention, the fall rate was significantly reduced to 0.07% (β ̂= -0.37, p = .02); however, here was no significant effect on fall-related injury (β ̂= 0.25, p = .64). In addition, the compliance rate of utilising fall-prevention guidelines among health professionals was significantly improved up to 95.0% (mean difference = -8.52, 95% CI -10.29~ -6.75, t = -9.48, p < .001).

Conclusions: The application of the "knowledge-to-action conceptual framework" and information strategies in study hospital significantly reduced the fall rate, and increased the compliance rate of fall-prevention guideline among health professionals. However, the fall-related injuries were not significantly improved. Further research is needed on fall-prevention strategies.