Implementation of evidence-based fall prevention in clinical services for high-risk clients

Rationale, aims and objectives: The extent to which best practice for falls prevention is being routinely delivered by health care providers for community-dwelling older adults is unclear. We investigated falls prevention practice among Hospital Admission Risk Programs (HARP) that provide and coordi...

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Main Authors: Day, L., Trotter, M., Hill, Keith, Haines, T., Thompson, C.
Format: Journal Article
Published: Wiley-Blackwell Publishing 2014
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/15338
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author Day, L.
Trotter, M.
Hill, Keith
Haines, T.
Thompson, C.
author_facet Day, L.
Trotter, M.
Hill, Keith
Haines, T.
Thompson, C.
author_sort Day, L.
building Curtin Institutional Repository
collection Online Access
description Rationale, aims and objectives: The extent to which best practice for falls prevention is being routinely delivered by health care providers for community-dwelling older adults is unclear. We investigated falls prevention practice among Hospital Admission Risk Programs (HARP) that provide and coordinate specialized health care for people at high risk of hospitalization. Method: Cross-sectional survey of all HARP services in Victoria, excluding one paediatric programme (n = 34). The questionnaire focused upon medication review and exercise prescription, as these are the evidence-based falls interventions with a good fit with HARP services. Results: Completed questionnaires were received from 24 programmes (70.6%) that service 15 250 older clients (60+ years). All except one programme screened for medicine use; however, a lower proportion (65% of those that screen) target falls risk medications. Among the 17 programmes responding to the exercise prescription question, all routinely include strengthening exercises, and almost all (n = 15) include flexibility, endurance training and movement of the centre of gravity. A lesser proportion (71%) includes reducing the need for upper limb support. The majority of services (88%) undertake falls risk assessments, and all of these either make referral appointments for clients or refer to other services that make referral appointments for clients. Follow-up of appointments and the resulting recommendations was high. Conclusion: Screening for falls risk medications could be improved and staff training in exercise prescription for balance challenge in this high-risk group may be needed. Although evidence-based falls prevention practice within Victorian HARP services appears strong, the effect on falls risk may not be as high as that achieved in randomized trials.
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spelling curtin-20.500.11937-153382017-09-13T13:40:19Z Implementation of evidence-based fall prevention in clinical services for high-risk clients Day, L. Trotter, M. Hill, Keith Haines, T. Thompson, C. evidence-based medicine evaluation Rationale, aims and objectives: The extent to which best practice for falls prevention is being routinely delivered by health care providers for community-dwelling older adults is unclear. We investigated falls prevention practice among Hospital Admission Risk Programs (HARP) that provide and coordinate specialized health care for people at high risk of hospitalization. Method: Cross-sectional survey of all HARP services in Victoria, excluding one paediatric programme (n = 34). The questionnaire focused upon medication review and exercise prescription, as these are the evidence-based falls interventions with a good fit with HARP services. Results: Completed questionnaires were received from 24 programmes (70.6%) that service 15 250 older clients (60+ years). All except one programme screened for medicine use; however, a lower proportion (65% of those that screen) target falls risk medications. Among the 17 programmes responding to the exercise prescription question, all routinely include strengthening exercises, and almost all (n = 15) include flexibility, endurance training and movement of the centre of gravity. A lesser proportion (71%) includes reducing the need for upper limb support. The majority of services (88%) undertake falls risk assessments, and all of these either make referral appointments for clients or refer to other services that make referral appointments for clients. Follow-up of appointments and the resulting recommendations was high. Conclusion: Screening for falls risk medications could be improved and staff training in exercise prescription for balance challenge in this high-risk group may be needed. Although evidence-based falls prevention practice within Victorian HARP services appears strong, the effect on falls risk may not be as high as that achieved in randomized trials. 2014 Journal Article http://hdl.handle.net/20.500.11937/15338 10.1111/jep.12119 Wiley-Blackwell Publishing restricted
spellingShingle evidence-based medicine
evaluation
Day, L.
Trotter, M.
Hill, Keith
Haines, T.
Thompson, C.
Implementation of evidence-based fall prevention in clinical services for high-risk clients
title Implementation of evidence-based fall prevention in clinical services for high-risk clients
title_full Implementation of evidence-based fall prevention in clinical services for high-risk clients
title_fullStr Implementation of evidence-based fall prevention in clinical services for high-risk clients
title_full_unstemmed Implementation of evidence-based fall prevention in clinical services for high-risk clients
title_short Implementation of evidence-based fall prevention in clinical services for high-risk clients
title_sort implementation of evidence-based fall prevention in clinical services for high-risk clients
topic evidence-based medicine
evaluation
url http://hdl.handle.net/20.500.11937/15338