一份个体化、促进和可持续实施当前预防老年人居住设施跌倒证据的方案。
A protocol for an individualised, facilitated and sustainable approach to implementing current evidence in preventing falls in residential aged care facilities.
机构信息
Preventive and Public Health Division, National Ageing Research Institute, 34-54 Poplar Rd, Parkville 3052, Australia.
出版信息
BMC Geriatr. 2010 Feb 17;10:8. doi: 10.1186/1471-2318-10-8.
BACKGROUND
Falls are common adverse events in residential care facilities. Commonly reported figures indicate that at least 50% of residents fall in a 12 month period, and that this figure is substantially higher for residents with dementia. This paper reports the protocol of a project which aims to implement evidence based falls prevention strategies in nine residential aged care facilities (RACFs) in Australia. The facilities in the study include high and low care, small and large facilities, metropolitan and regional, facilities with a specific cultural focus, and target groups recognised as being more challenging to successful implementation of falls prevention practice (e.g. residents with dementia).
METHODS
The project will be conducted from November 2007-November 2009. The project will involve baseline scoping of existing falls rates and falls prevention activities in each facility, an action research process, interactive falls prevention training, individual falls risk assessments, provision of equipment and modifications, organisation based steering committees, and an economic evaluation. In each RACF, staff will be invited to join an action research group that will lead the process of developing and implementing interventions designed to facilitate an evidence based approach to falls management in their facility. In all RACFs a pre/post design will be adopted with a range of standardised measures utilised to determine the impact of the interventions.
DISCUSSION
The care gap in residential aged care that will be addressed through this project relates to the challenges in implementing best practice falls prevention actions despite the availability of best practice guidelines. There are numerous factors that may limit the uptake of best practice falls prevention guidelines in residential aged care facilities. A multi-factorial individualised (to the specific requirements of each facility) approach will be used to develop and implement an action plan in each participating facility based on the best available evidence.
背景
跌倒在养老院中是常见的不良事件。常见报告数据显示，至少 50%的居民在 12 个月内跌倒，而痴呆症患者的这一比例要高得多。本文报告了一个项目的方案，该项目旨在将循证预防跌倒策略在澳大利亚的 9 家养老院中实施。该研究中的设施包括高、低护理，大、小设施，大都市和区域，有特定文化焦点的设施，以及被认为更难以成功实施跌倒预防实践的目标群体（例如患有痴呆症的居民）。
方法
该项目将于 2007 年 11 月至 2009 年 11 月进行。该项目将包括对每个设施现有的跌倒率和跌倒预防活动进行基线调查，一个行动研究过程，互动式跌倒预防培训，个体跌倒风险评估，提供设备和修改，以组织为基础的指导委员会，以及经济评估。在每个养老院中，将邀请工作人员加入行动研究小组，该小组将领导制定和实施干预措施的过程，旨在促进其设施内基于证据的跌倒管理方法。在所有养老院中，将采用前后设计，利用一系列标准化措施来确定干预措施的影响。
讨论
该项目将解决养老院中存在的护理差距问题，该差距与尽管有最佳实践指南，但在实施最佳实践预防跌倒措施方面所面临的挑战有关。在养老院中实施最佳实践预防跌倒指南可能会受到许多因素的限制。将采用多因素个体化（针对每个设施的具体要求）方法，根据最佳现有证据，为每个参与的设施制定和实施行动计划。
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