Mediating Role of Fall-related Efficacy in a Fall Prevention Program

Introduction Approximately 27.5% of adults 65 and older fall each year, over 3 million are treated in an emergency department, and 32 000 die. The American College of Surgeons and its Committee on Trauma (ACSCOT) have urged trauma centers (TCs) to screen for fall risk, but information on the role of TC in this opportunity for prevention is largely unknown. Methods A 29-item survey was developed by an ACSCOT Injury Prevention and Control Committee, Older Adult Falls workgroup, and emailed to 1000 trauma directors of the National Trauma Data Bank using Qualtrics. US TCs were surveyed regarding fall prevention, screening, intervention, and hospital discharge practices. Data collected and analyzed included respondent’s role, location, population density, state designation or American College of Surgeons (ACS) level, if teaching facility, and patient population. Results Of the 266 (27%) respondents, 71% of TCs include fall prevention as part of their mission, but only 16% of TCs use fall risk screening tools. There was no significant difference between geographic location or ACS level. The number of prevention resources (F = 31.58, P < .0001) followed by the presence of a formal screening tool (F = 21.47, P < .0001) best predicted the presence of a fall prevention program. Conclusion Older adult falls remain a major injury risk and injury prevention opportunity. The majority of TCs surveyed include prevention of older adult falls as part of their mission, but few incorporate the components of a fall prevention program. Development of best practices and requiring TCs to screen and offer interventions may prevent falls.

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Fall prevention program yields benefits at first then wanes

PsycEXTRA Dataset ◽

10.1037/e504332010-005 ◽

2008 ◽

Keyword(s):

Fall Prevention ◽

Prevention Program ◽

Fall Prevention Program

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Best Practices for Data Visualization: Creating and Evaluating a Report for an Evidence-Based Fall Prevention Program (Preprint)

10.2196/preprints.12801 ◽

2018 ◽

Author(s):

Srijesa Khasnabish ◽

Zoe Burns ◽

Madeline Couch ◽

Mary Mullin ◽

Randall Newmark ◽

...

Keyword(s):

Literature Review ◽

Best Practices ◽

Implementation Science ◽

Data Visualization ◽

Systematic Literature Review ◽

Fall Prevention ◽

Prevention Program ◽

Evidence Based ◽

Data Display ◽

Fall Prevention Program

BACKGROUND Data visualization experts have identified core principles to follow when creating visual displays of data that facilitate comprehension. Such principles can be applied to creating effective reports for clinicians that display compliance with quality improvement protocols. A basic tenet of implementation science is continuous monitoring and feedback. Applying best practices for data visualization to reports for clinicians can catalyze implementation and sustainment of new protocols. OBJECTIVE To apply best practices for data visualization to create reports that clinicians find clear and useful. METHODS First, we conducted a systematic literature review to identify best practices for data visualization. We applied these findings and feedback collected via a questionnaire to improve the Fall TIPS Monthly Report (FTMR), which shows compliance with an evidence-based fall prevention program, Fall TIPS (Tailoring Interventions for Patient Safety). This questionnaire was based on the requirements for effective data display suggested by expert Stephen Few. We then evaluated usability of the FTMR using a 15-item Health Information Technology Usability Evaluation Scale (Health-ITUES). Items were rated on a 5-point Likert scale from strongly disagree (1) to strongly agree (5). RESULTS The results of the systematic literature review emphasized that the ideal data display maximizes the information communicated while minimizing the cognitive efforts involved with data interpretation. Factors to consider include selecting the correct type of display (e.g. line vs bar graph) and creating simplistic reports. The qualitative and quantitative evaluations of the original and final FTMR revealed improved perceptions of the visual display of the reports and their usability. Themes that emerged from the staff interviews emphasized the value of simplified reports, meaningful data, and usefulness to clinicians. The mean (SD) rating on the Health-ITUES scale when evaluating the original FTMR was 3.86 (0.19) and increased to 4.29 (0.11) when evaluating the revised FTMR (Mann Whitney U Test, z=-12.25, P<0.001). CONCLUSIONS Best practices identified through a systematic review can be applied to create effective reports for clinician use. The lessons learned from evaluating FTMR perceptions and measuring usability can be applied to creating effective reports for clinician use in the context of other implementation science projects.

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A Systematic Review and Meta-Analysis of Fall Prevention Programs for Pediatric Inpatients

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115853 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5853

Author(s):

Eun-Joo Kim ◽

Geun-Myun Kim ◽

Ji-Young Lim

Keyword(s):

High Risk ◽

Fall Prevention ◽

Prevention Program ◽

Meta Analysis ◽

Prevention Programs ◽

Fall Prevention Program ◽

Medium Risk ◽

Randomized Control ◽

Reduction Effect ◽

Future Randomized Control Trial

Falls account for a high proportion of the safety accidents experienced by hospitalized children. This study aims to analyze the contents and effects of fall prevention programs for pediatric inpatients to develop more adaptable fall prevention programs. A literature search was performed using PubMed (including Medline), Science Direct, CINAHL, Embase, and Cochrane. We included articles published from the inception of each of the databases up to 31 March 2019. A total of 1725 results were reviewed according to the inclusion and exclusion criteria, and nine studies were selected. Data were analyzed using descriptive statistics and the Comprehensive Meta-Analysis program. Four of the nine studies divided their participants into a high-risk fall group and a low-or medium-risk fall group, and all studies used a high-risk sign/sticker as a common protocol guideline for its high-risk fall group. The odds ratio of 0.95 (95% Cl 0.550–1.640) for the fall prevention program in seven studies was not statistically significant. To develop a standardized fall prevention program in the future, randomized control trial studies that can objectively measure the fall rate reduction effect of the integrated fall prevention program need to be expanded.

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Predictors for Confidence in Self-Management of Falls and the Role of Fear of Falls

Innovation in Aging ◽

10.1093/geroni/igaa057.964 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 301-301

Author(s):

Qiwei Li ◽

Becky Knight

Keyword(s):

Older Adults ◽

Fall Prevention ◽

Predictor Variable ◽

Path Model ◽

Self Management ◽

Hierarchical Regression ◽

Mediating Role ◽

Self Protection ◽

Fear Of Falls

Abstract Falls have been a crucial threat for older adults to stay independent. Once they have fallen, older adults are more likely to receive injuries and become people with disabilities. Conventionally, the measurement of fall efficacy focused on the capacity of performing certain activities such as walking or bathing without a fall. However, given the fact that one out of five older adults fall every year, self-efficacy in self-protection when falls do happen calls for a better understanding of confidence in self-management of a fall. Among predictors for fall prevention outcomes, “fear of falls” has received attention. However, “fear of falls” was largely missing in studies exploring self-management of falls in scenarios where falls do happen. This study explores the predictors for CSMoF including “fear of falls”. A series of simultaneous and hierarchical regression analyses with related interaction analyses and a path model were applied to determine the contribution of each predictor variable and the mediating role of “fear of falls”. The findings of the study reported that demographic characteristics, chronic conditions, and perceptions of falls were associated with CSMoF. The path analysis confirmed the mediating role of “fear of falls” as the indirect effects were occupying substantial percentages in the total identified effects. “Fear of falls” should continue to be a core of fall prevention programs and is particularly important for programs that aim to teach older adults what to do when they fall, whom to call for help, and how to avoid injuries upon falling.

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Effect of a Fall Prevention Program on Balance Maintenance Using a Quasi-experimental Design in Real-World Settings

Journal of Aging and Health ◽

10.1177/0898264312436713 ◽

2012 ◽

Vol 24 (5) ◽

pp. 827-845 ◽

Cited By ~ 5

Author(s):

Yvonne Robitaille ◽

Michel Fournier ◽

Sophie Laforest ◽

Lise Gauvin ◽

Johanne Filiatrault ◽

...

Keyword(s):

Real World ◽

Fall Prevention ◽

Prevention Program ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Community Dwelling ◽

Balance Performance ◽

Community Based ◽

Fall Prevention Program ◽

Quasi Experimental

Objectives: To examine the effect of a fall prevention program offered under real-world conditions on balance maintenance several months after the program. To explore the program’s impact on falls. Method: A quasi-experimental study was conducted among community-dwelling seniors, with pre- and postintervention measures of balance performance and self-reported falls. Ten community-based organizations offered the intervention (98 participants) and 7 recruited participants to the study’s control arm (102 participants). An earlier study examined balance immediately after the 12-week program. The present study focuses on the 12-month effect. Linear regression (balance) and negative binomial regression (falls) procedures were performed.falls. Results: During the 12-month study period, experimental participants improved and maintained their balance as reflected by their scores on three performance tests. There was no evidence of an effect on falls.falls. Discussion: Structured group exercise programs offered in community-based settings can maintain selected components of balance for several months after the program’s end.

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Fall Prevention Program in the Community: A Nurse Practitioner’s Contribution

The Journal for Nurse Practitioners ◽

10.1016/j.nurpra.2017.06.017 ◽

2017 ◽

Vol 13 (8) ◽

pp. e395-e397 ◽

Cited By ~ 2

Author(s):

Barbara E. Harrison

Keyword(s):

Fall Prevention ◽

Prevention Program ◽

Fall Prevention Program

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Effects of a Fall Prevention Program on Physical Functions and Psychological Functions in Rural Elderly Women

The Korean Journal of Rehabilitation Nursing ◽

10.7587/kjrehn.2012.63 ◽

2012 ◽

Vol 15 (1) ◽

pp. 63-71 ◽

Cited By ~ 2

Author(s):

Sung-Min Kim ◽

Go-Ya Choi

Keyword(s):

Fall Prevention ◽

Prevention Program ◽

Elderly Women ◽

Rural Elderly ◽

Fall Prevention Program ◽

Physical Functions ◽

Psychological Functions

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The Stepping On Fall Prevention Program Scale-Up in NSW: Program Reach and Fall-Related Health Service Use

International Journal for Population Data Science ◽

10.23889/ijpds.v5i5.1538 ◽

2020 ◽

Vol 5 (5) ◽

Author(s):

Serene S Paul ◽

Qiang Li ◽

Lara Harvey ◽

Therese Carroll ◽

Annabel Priddis ◽

...

Keyword(s):

Health Service ◽

Fall Prevention ◽

Prevention Program ◽

Service Use ◽

Hospital Admissions ◽

Scale Up ◽

Service Utilisation ◽

Program Outcomes ◽

Fall Prevention Program ◽

Routinely Collected Data

IntroductionFalls in older adults are associated with increased healthcare costs. Falls may be prevented or minimised with multifactorial interventions including exercise and behavioural modification. Objectives and ApproachTo describe the reach of the scale-up of Stepping On, a fall prevention program targeting community-dwellers aged 65 years and older in NSW, Australia; and fall-related ambulance service use and fall-related hospitalisations after scale-up. Routinely-collected data on program reach, fall-related ambulance usage and fall-related hospital admissions in NSW residents aged ≥65 years between 2009 and 2015 were compared within Statistical Local Areas prior to and following implementation of Stepping On using multilevel models. ResultsFrom 2009 to 2014 the program was delivered in 1,077 sites to 10,096 people with an average (SD) age of 81.0 (7.2) years. Rates of fall-related ambulance use and hospital admissions per 100-person-years were 1-2 in people aged 66-74, 4-5 in people aged 75-84 and 12-13 in people aged ≥85. These rates increased over time (p<.001). Overall, the interaction between time and program delivery was not significant for fall-related ambulance use or hospital admissions. The time-related increase in fall-related ambulance usage in people aged 75-84 years may have been moderated by Stepping On (RR 0.97, 95% CI 0.93–1.00, p=.045). Conclusion / ImplicationsThere was no indication of either a reduced rate of fall-related ambulance use or hospital admissions across the entire sample. There was a suggestion of a reduction in ambulance call-outs for falls in people aged 75-84. The lack of a detectable impact on fall-related health service usage may be due to the use of routinely collected data not intended for research purposes or inability to remove those who would be ineligible for Stepping On from the data analyses. Increasing the program reach and targeting groups contributing most to health service utilisation may improve program outcomes.

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