A Survey of Fall Prevention Knowledge and Practice Patterns in Home Health Physical Therapists

Peel, Claire; Brown, Cynthia J.; Lane, Amanda; Milliken, Elizabeth; Patel, Kinnery

doi:10.1519/00139143-200831020-00005

Cited by 26 publications

(33 citation statements)

References 15 publications

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“…Commonly cited barriers to adoption include the lack of time, training opportunities, financial incentives, and coordination among healthcare providers, and the need for simpler and more easily disseminated materials and referral resources . In rehabilitation settings, Peel et al reported that although home physical therapists were knowledgeable in identifying fall risk factors, they had difficulty linking them to prescribed interventions or identifying available interventions …”

Section: Challengesmentioning

confidence: 99%

See 1 more Smart Citation

Exercise and Fall Prevention: Narrowing the Research‐to‐Practice Gap and Enhancing Integration of Clinical and Community Practice

Eckstrom

Harmer

et al. 2016

J American Geriatrics Society

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Falls in older adults are a global public health crisis, but mounting evidence from randomized controlled trials shows that falls can be reduced through exercise. Public health authorities and healthcare professionals endorse the use of evidence‐based, exercise‐focused fall interventions, but there are major obstacles to translating and disseminating research findings into healthcare practice, including lack of evidence of the transferability of efficacy trial results to clinical and community settings, insufficient local expertise to roll out community exercise programs, and inadequate infrastructure to integrate evidence‐based programs into clinical and community practice. The practical solutions highlighted in this article can be used to address these evidence‐to‐practice challenges. Falls and their associated healthcare costs can be reduced by better integrating research on exercise intervention into clinical practice and community programs.

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Section: Challengesmentioning

confidence: 99%

“…[25][26][27] In rehabilitation settings, Peel et al reported that although home physical therapists were knowledgeable in identifying fall risk factors, they had difficulty linking them to prescribed interventions or identifying available interventions. 28…”

Section: Adoption Of Guidelines By Healthcare Providers Is Limitedmentioning

confidence: 99%

Exercise and Fall Prevention: Narrowing the Research‐to‐Practice Gap and Enhancing Integration of Clinical and Community Practice

Eckstrom

Harmer

et al. 2016

J American Geriatrics Society

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“…In scoping the literature on safety with home care, an interesting aspect is the particular perspective of healthcare 6,7,28,43,47,48,50,52,64,[66][67][68][69][70][71][72][73][74][75] 18 Injuries 43,47,76,77 4 Hip fracture 78 1 Infection 47, 79 2 New pneumonia 6,7, 80 2 New urinary tract infection 6,7,43,48,64,79 5 Central-line blood stream infection [81][82][83][84][85] 5 Catheter related urinary tract infection 81 1 New bowel problem 6,7 1 Unintended weight loss 6,7, 86 2 New dehydration 6, 7 1 Hypo/hyper glycemia 13,37,43,48,50,87 5 Diarrhoea 13, 45 1 Nausea 45,...…”

Section: Perspectivementioning

confidence: 99%

“…10,13 Furthermore, family and friends as caregivers placed a level of complexity upon the relationship that confounded the ability to recognise and respond to AEs such as abuse or neglect. 94 Eight studies 9,[36][37][38][39]59,69,99 addressed AEs from the perspective of healthcare providers. Of this set, the study sample of four studies was nurses, 36,38,39,99 two studies addressed nursing assistants and nurse aids, 37,59 one study 69 targeted physiotherapists, and one other study 9 addressed nurses and a range of healthcare professionals including decision makers, administrative executives, case managers and physicians.…”

Section: Caregiver Instigated Injury/harmmentioning

confidence: 99%

Safety in home care: a mapping review of the international literature

Harrison

Keeping‐Burke

Godfrey

et al. 2013

International Journal of Evidence-Based Healthcare

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Aim This integrative study on safety in home care provides a synopsis of evidence in the Canadian and international literature. The objectives of this study were to: (i) develop/test a comprehensive search strategy to locate the literature on harmful incidents (previously called adverse events (AEs)) in the home care environment to track emerging evidence; (ii) determine what has been documented about AEs in the home care setting; and (iii) catalogue definitions of safety in home care by analysis of reported/published definitions. Methods The review was characterised by a process of mapping and categorising existing literature in practice, health services and policy literature. Methods included a thorough search strategy determined by time/scope constraints, quality assessment of study sets relevant to design and graphic/tabular representation of the synthesis. This multi‐step, iterative process used an explicit search and retrieval strategy based on Cochrane and Joanna Briggs Institute methodologies. A modified Problem, Intervention, Comparison, Outcome template was used to design the search. To facilitate concept clarification, key definitions relevant to patient safety and AEs in home care were catalogued. Results Multiple runs on searches were performed for sensitivity and specificity using the Peer Review of Electronic Search Strategies methodology developed by the Canadian Agency for Drugs and Technologies in Health and additional other approaches. Ninety‐two research studies published from 1993 to 2010 and representing 14 countries (the majority North American) met the inclusion criteria (i.e. addressing AEs within the context of home care). Studies varied in scope from one home healthcare agency/site to nationwide investigations that involved more than five million participants. Quantitative research methods included experimental, descriptive and retrospective designs. Qualitative research methods included focus groups, interviews and consensus workshops. The nature of AEs was categorised as types of patient injury/harm related to an AE, caregiver instigated injury/harm and organisational/services/staff injury/harm. Conclusions There is an emerging evidence base about safety in home care. A predominant theme was the lack of conceptual clarity with the terms patient safety and AEs in the home care environment. An important finding was that innovative strategies/tools appear in the grey or peer‐review literature as quality initiatives with/without evaluation elements. Traditionally, we do not concentrate heavily on the grey literature, but to advance the field, it may be necessary to place more emphasis on this source. A glaring limitation was the paucity of research on the occurrence of AEs and a lack of quality of research that documents prevalence estimates/incidence rates. Interventional research to evaluate risk reduction strategies was very limited and will advance only when tracking and documentation of various AEs improves.

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“…Hospitals and quality assurance organizations have made falls prevention a priority, and public health groups have focused increasing attention on this topic. The American Geriatrics Society (AGS) and British Geriatrics Society (BGS) released guidelines in 2011 for evidence‐based falls prevention practices, but clinical teams have not widely adopted these guidelines …”

mentioning

confidence: 99%

An Interprofessional Approach to Reducing the Risk of Falls Through Enhanced Collaborative Practice

Eckstrom

Neal

Cotrell

et al. 2016

J American Geriatrics Society

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Falls are the leading cause of accidental deaths in older adults and are a growing public health concern. The American Geriatrics Society/British Geriatrics Society (AGS/BGS) published guidelines for falls screening and risk reduction, yet few primary care providers report following any guidelines for falls prevention. This manuscript describes a project that engaged an interprofessional (IP) teaching team to support IP clinical teams to reduce fall risk in older adults via implementation of the AGS/BGS guidelines. Twenty-five IP clinical teams with representatives from medicine, nursing, pharmacy, and social work were recruited from ambulatory, long-term care, hospital, and home health settings for a structured intervention: a 4-hour training workshop plus “coaching” for implementation for one year. The workshop focused on evidence-based strategies to decrease the risk of falls, including screening for falls; assessing gait, balance, orthostatics and other medical conditions; exercise including tai chi; vitamin D supplementation; medication review and reduction; and environmental assessment. Quantitative and qualitative data were collected via chart review, coaching plans and field notes, and post-intervention structured interviews of participants. Site visits and coaching field notes confirmed uptake of the strategies. Chart reviews showed a significant improvement in adoption of all falls prevention strategies except vitamin D supplementation. Long-term care facilities were more likely to address environmental concerns and add tai chi classes while ambulatory settings were more likely to initiate falls screening. The intervention demonstrated that interprofessional practice change to target falls prevention can be incorporated into primary care and long-term care settings.

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A Survey of Fall Prevention Knowledge and Practice Patterns in Home Health Physical Therapists

Cited by 26 publications

References 15 publications

Exercise and Fall Prevention: Narrowing the Research‐to‐Practice Gap and Enhancing Integration of Clinical and Community Practice

Exercise and Fall Prevention: Narrowing the Research‐to‐Practice Gap and Enhancing Integration of Clinical and Community Practice

Safety in home care: a mapping review of the international literature

An Interprofessional Approach to Reducing the Risk of Falls Through Enhanced Collaborative Practice

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