Fall assessment and intervention among community-dwelling older people in a primary health care center in Spain: a best practice implementation project.

IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Jbi Evidence Implementation Pub Date : 2024-06-26 DOI:10.1097/XEB.0000000000000440
María García Fernández, Mónica Martínez Pantiga, Carmen Pino Fernández, Laura Albornos Muñoz, Carmen Gutierrez Guerrero
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Abstract

Introduction: The implementation of fall prevention programs in the community is complex. Although there is solid scientific evidence that supports the effectiveness of such programs, there are multiple barriers that should be addressed using multifaceted strategies.

Aims: The aim of this project was to increase compliance with evidence-based recommendations regarding fall risk screening and preventive interventions among older adults in a primary health care setting.

Methods: This project used a pre-/post-implementation clinical audit based on the JBI Evidence Implementation Framework. Eight audit criteria were derived from JBI evidence summaries. The sample size was 62 patients aged 70 years or older. Data collection methods included a review of medical records and a questionnaire. A baseline audit was conducted and five barriers to best practice were identified. Strategies were then developed to increase compliance with the evidence-based recommendations, guided by JBI's Getting Research into Practice (GRiP) analysis. A follow-up audit was conducted in July 2022 to evaluate changes in compliance with best practices.

Results: The baseline audit showed 0% compliance with best practice recommendations for seven out of eight audit criteria. Five barriers were identified: (1) absence of fall risk screening tools, (2) lack of fall prevention intervention protocols, (3) insufficient reporting of fall episodes in the records, (4) need for staff training, and (5) high staff turnover. Following the implementation of a fall risk assessment and intervention protocol, along with staff training, seven out of eight audit criteria increased from 0% to between 22.6% and 100%.

Conclusions: This evidence-based implementation project improved nursing practice in relation to compliance with best practice interventions to prevent falls.

Spanish abstract: http://links.lww.com/IJEBH/A229.

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西班牙一家初级医疗保健中心对居住在社区的老年人进行跌倒评估和干预:最佳实践实施项目。
前言在社区实施跌倒预防计划是一项复杂的工作。尽管有确凿的科学证据支持此类计划的有效性,但仍存在多种障碍,应采用多方面的策略加以解决。目的:本项目旨在提高基层医疗机构中老年人对有关跌倒风险筛查和预防干预措施的循证建议的依从性:方法:该项目采用基于 JBI 循证实施框架的实施前/后临床审核。八项审核标准来自 JBI 证据摘要。样本量为 62 名 70 岁或以上的患者。数据收集方法包括审查医疗记录和问卷调查。通过基线审核,确定了最佳实践的五个障碍。随后,在 JBI 的 "将研究付诸实践"(GRiP)分析指导下,制定了提高循证建议依从性的策略。2022 年 7 月进行了一次后续审计,以评估最佳实践遵守情况的变化:基线审计显示,在八项审计标准中,有七项与最佳实践建议的符合率为 0%。发现了五个障碍(1) 缺乏跌倒风险筛查工具,(2) 缺乏预防跌倒干预方案,(3) 记录中对跌倒事件的报告不足,(4) 需要对员工进行培训,以及 (5) 员工流失率高。在实施了跌倒风险评估和干预方案以及员工培训后,八项审计标准中的七项从 0% 提高到了 22.6% 到 100% 之间:该循证实施项目改善了护理实践中对预防跌倒最佳干预措施的遵守情况。西班牙文摘要:http://links.lww.com/IJEBH/A229。
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CiteScore
3.20
自引率
13.00%
发文量
23
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