Tackling a persistent problem: in-hospital falls prevention
Falls are one of the most common adverse events in hospitals worldwide. Patients are usually admitted to hospital due to a change in physical or cognitive condition, which combined with unfamiliar surroundings, presents a high risk for falls. Injuries resulting from falls can be serious, in some cases leading to chronic pain, functional impairment, permanent disability or death. Falls often result in increased length of hospital stay, reduced quality of life, and can leave patients with emotional distress and fear of a repeat fall. In addition to the detrimental effects on patients, in-hospital falls lead to significant increases in healthcare costs putting added strain on healthcare systems.
Despite the existence of evidence-based guidelines for the prevention of falls in hospital settings, many preventable falls continue to occur every day. To tackle this problem, the Joanna Briggs Institute (JBI) aimed to assess the state of falls prevention practices at multiple hospitals around Australia and implement strategies to promote best practice and reduce falls. JBI received funding from the Hospital Contributions Fund (HCF) Health and Medical Research Foundation for this purpose and recruited staff members from a selection of Australian hospitals to participate in the project.
To obtain a diverse sample representative of Australian hospitals, one staff member was sought from a public hospital and one from a private hospital in each of the five mainland states of Australia (Queensland, New South Wales, Victoria, South Australia and Western Australia). Participants received training in clinical leadership and evidence implementation and, using audit criteria informed by the best available evidence, conducted baseline audits in their clinical settings. Where possible, a medical ward and a surgical ward from each hospital were included. Baseline audit results were presented to local multidisciplinary project teams and strategies developed and implemented to improve compliance with best practice. Two follow-up audit cycles assessed the effects of the implemented interventions on falls prevention practices and the sustainability of practice change.
In this special issue of the JBI Database of Systematic Reviews and Implementation Reports, we are pleased to present the series of Implementation Reports developed by the project participants. These reports detail the falls prevention projects conducted at individual hospital sites. By publishing these reports together in this special issue we hope you will be able to gain an understanding of the similarities and differences encountered at each of the sites. Across the board, the results of these projects were positive and demonstrated sustained improvements in falls prevention practices for all hospitals that participated.
These Implementation Reports enhance our knowledge and understanding of the use of evidence in clinical practice and the mechanisms by which the implementation of research evidence can be achieved. It is heartening to see improvements in clinical practice achieved in a relatively short amount of time across multiple sites, and to see improvements maintained beyond the initial focus of the projects. Ultimately, the promotion of best practice in falls prevention will lead to improved safety and quality of care, resulting in benefits for patients and healthcare systems.
Research Fellow, The Joanna Briggs Institute