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

Abstract

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