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

Kee-Hsin Chen, Hsueh Erh Liu, Tso-Hsiao Chen, H.C. Su, K.N. Kuo, C.C Chen

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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.
Original languageEnglish
JournalCochrane Database of Systematic Reviews
Issue number9
Publication statusPublished - Sep 16 2017

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