Poster Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2025

Development of an acute hospital fall prevention program (119883)

Charlotte McLennan 1 , Abby Haynes 2 , Vasi Naganathan 3 , Wendy Tilden 4 , Suzanne Dyer 5 , Cathie Sherrington 2
  1. Sydney Local Health District & University of Sydney, Camperdown, NSW, Australia
  2. School of Public Health , University of Sydney, Sydney, Australia
  3. Centre for Education and Research on Ageing, Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Concord Hospital and The University of Sydney, Sydney, New South Wales, Australia
  4. Sydney Local Health District, Sydney, New South Wales, Australia
  5. Flinders Health and Medical Research, Institute College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia

Introduction

Falls in hospitals continue to burden patients, staff and health systems. While multifactorial prevention approaches and patient education have shown positive results in subacute settings, multifactorial interventions in acute settings have not been proven effective in large trials. We aimed to design an evidence-informed hospital fall prevention program which reflects the diverse needs and challenges in acute hospitals.

Method

Three projects informed the design of our program: an Intervention Component Analysis (ICA) of 45 hospital falls trials in a Cochrane review update, a qualitative study with 50 hospital staff and patients, and a feasibility study of supported implementation of tailored multicomponent fall prevention interventions across four hospital wards, evaluated via staff pre- and post-implementation surveys and post-implementation interviews.

Results

ICA: Contextually tailored approaches and involvement of ward staff, patients and families in fall prevention emerged as features that may impact effectiveness of interventions.

Qualitative study: Considerations when implementing hospital fall prevention programs include: 1) Fall prevention is a priority, but whose? 2) Disempowered stakeholders, 3) Shared responsibility may be a solution.

Feasibility study: 97 surveys and 14 interviews revealed staff perceived the implementation strategies to be acceptable (mean score 7.4/10) and feasible. Barriers and facilitators relevant to the intervention, implementation strategies, recipients and context were identified.

Implications

These projects have informed the PROTECT Fall Prevention Program. PROTECT will provide 12 inpatient wards with 21 weeks of supported implementation of tailored fall prevention interventions informed by local needs analyses. The program will be evaluated in a stepped wedge trial.