‘It promoted a positive culture around falls prevention’: staff response to a patient education programme—a qualitative evaluation

Hill, Anne‐Marie; Waldron, Nicholas; Francis‐Coad, Jacqueline; Haines, Terry; Etherton‐Beer, Christopher; Flicker, Leon; Ingram, Katharine; McPhail, Steven

doi:10.1136/bmjopen-2016-013414

Cited by 17 publications

(35 citation statements)

References 28 publications

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“…Of the included articles, five were systematic reviews (Table 1) [14,37,[47][48][49], three were targeted literature reviews [6,50,51], 10 were randomised controlled trials (RCTs) ( Table 2) [30-32, 34, 38, 52, 53, 55, 57], three were qualitative studies [58][59][60], and three were unpublished theses [61][62][63]. The remaining studies were quasiexperimental trials (n = 18).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Haines et al [64] examined economic evaluations of falls prevention programs following an RCT [30]. Three qualitative studies reported staff [58], educator [59] and participant perspectives [60] following an intervention carried out in an earlier study [38]. For the purposes of this scoping review, investigations such as these were analysed together.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Most of the trials were in an acute hospital setting (n = 22). Seven were conducted in sub-acute settings [36,38,52,[58][59][60]65] and six included both acute and sub-acute hospital wards [30,53,55,64,66,67]. Six studies reported including cognitively impaired patients [30,36,38,52,53,65].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Most of the trials showed an improvement in falls outcomes, with seven reporting otherwise [28,30,52,53,56,66,71]. Other outcomes included the impact of falls prevention interventions on staff knowledge and practice [31,58,71], patient adherence to the falls prevention interventions [32,61,69], changes in gait and balance [66], and economic outcomes [64,68,69]. Overall, the literature showed positive benefits of hospital falls education.…”

Section: Fall-related Outcomesmentioning

confidence: 99%

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Hospital falls prevention with patient education: a scoping review

et al. 2020

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Background: Hospital falls remain a frequent and debilitating problem worldwide. Most hospital falls prevention strategies have targeted clinician education, environmental modifications, assistive devices, hospital systems and medication reviews. The role that patients can play in preventing falls whilst in hospital has received less attention. This critical review scopes patient falls education interventions for hospitals. The quality of the educational designs under-pinning patient falls education programmes was also evaluated. The outcomes of patient-centred falls prevention programs were considered for a range of hospital settings and diagnoses. Methods: The Arksey and O'Malley (2005) framework for scoping reviews was adapted using Joanna Briggs Institute and PRISMA-ScR guidelines. Eight databases, including grey literature, were searched from January 2008 until February 2020. Two reviewers independently screened the articles and data were extracted and summarised thematically. The quality of falls prevention education programs for patients was also appraised using a modified quality metric tool. Results: Forty-three articles were included in the final analysis. The interventions included: (i) direct face-to-face patient education about falls risks and mitigation; (ii) educational tools; (iii) patient-focussed consumer materials such as pamphlets, brochures and handouts; and (iv) hospital systems, policies and procedures to assist patients to prevent falls. The included studies assessed falls or education related outcomes before and after patient falls prevention education. Few studies reported incorporating education design principles or educational theories. When reported, most educational programs were of low to moderate quality from an educational design perspective. Conclusions: There is emerging evidence that hospital falls prevention interventions that incorporate patient education can reduce falls and associated injuries such as bruising, lacerations or fractures. The design, mode of delivery and quality of educational design influence outcomes. Well-designed education programs can improve knowledge and self-perception of risk, empowering patients to reduce their risk of falling whilst in hospital.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Fall-related Outcomesmentioning

confidence: 99%

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Hospital falls prevention with patient education: a scoping review

et al. 2020

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“…Notably, one trial [ 19 ] had three qualitative studies published in the same journal: a qualitative interview study labelled as ‘a process evaluation’ [ 31 ], a qualitative questionnaire study reported as ‘informing the process evaluation’ [ 30 ], and a qualitative interview study labelled as a ‘qualitative evaluation’ [ 29 ]. However, the articles indicated that the studies were interlinked and formed a ‘sequential mixed-methods study’ [ 31 ].…”

Section: Resultsmentioning

confidence: 99%

Process evaluation within pragmatic randomised controlled trials: what is it, why is it done, and can we find it?—a systematic review

French

Pinnock

Forbes

et al. 2020

Trials

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Background Process evaluations are increasingly conducted within pragmatic randomised controlled trials (RCTs) of health services interventions and provide vital information to enhance understanding of RCT findings. However, issues pertaining to process evaluation in this specific context have been little discussed. We aimed to describe the frequency, characteristics, labelling, value, practical conduct issues, and accessibility of published process evaluations within pragmatic RCTs in health services research. Methods We used a 2-phase systematic search process to (1) identify an index sample of journal articles reporting primary outcome results of pragmatic RCTs published in 2015 and then (2) identify all associated publications. We used an operational definition of process evaluation based on the Medical Research Council’s process evaluation framework to identify both process evaluations reported separately and process data reported in the trial results papers. We extracted and analysed quantitative and qualitative data to answer review objectives. Results From an index sample of 31 pragmatic RCTs, we identified 17 separate process evaluation studies. These had varied characteristics and only three were labelled ‘process evaluation’. Each of the 31 trial results papers also reported process data, with a median of five different process evaluation components per trial. Reported barriers and facilitators related to real-world collection of process data, recruitment of participants to process evaluations, and health services research regulations. We synthesised a wide range of reported benefits of process evaluations to interventions, trials, and wider knowledge. Visibility was often poor, with 13/17 process evaluations not mentioned in the trial results paper and 12/16 process evaluation journal articles not appearing in the trial registry. Conclusions In our sample of reviewed pragmatic RCTs, the meaning of the label ‘process evaluation’ appears uncertain, and the scope and significance of the term warrant further research and clarification. Although there were many ways in which the process evaluations added value, they often had poor visibility. Our findings suggest approaches that could enhance the planning and utility of process evaluations in the context of pragmatic RCTs. Trial registration Not applicable for PROSPERO registration

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