Acceptability of the 6-PACK falls prevention program: A pre-implementation study in hospitals participating in a cluster randomized controlled trial
Acceptability of the 6-PACK falls prevention program: A pre-implementation study in hospitals participating in a cluster randomized controlled trial
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DOI：
10.1371/journal.pone.0172005
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发表时间：
2017-02-15
期刊：
影响因子：
3.7
通讯作者：
Botti, Mari
中科院分区：
文献类型：
--
作者：
Barker, Anna L.;Morello, Renata T.;Botti, Mari
有有限的证据支持预防跌倒干预措施的有效性在急性医院设置。6-PACK预防跌倒项目包括一个跌倒风险工具；“坠落警报”标志；在浴室对病人进行监督；确保患者触手可及助行设备；个人卫生制度;新低床;还有床/椅子警报器。本研究通过随机对照试验，从护士和高级医护人员的角度探讨了6-PACK计划实施前的可接受性。采用混合方法对澳大利亚6家医院的24个急症病房进行了研究。参与者是在参与病房工作的护士和高级医院工作人员，包括：护士单位经理；高级医师;护理主任；以及参与质量安全或防摔伤的高级人员。通过调查、焦点小组和访谈获得了项目可接受性（适用性、实用性和效益）的信息。对调查数据进行描述性分析，对焦点小组和访谈数据进行主题性分析。调查回应率为60%。共进行了12个焦点小组（96名护士）和24次高级护理人员访谈。跌倒被确定为优先的患者安全问题，护士是预防跌倒的关键角色。与目前的做法相比，6-PACK计划被认为提供了实际的好处。护士同意跌倒风险工具、低-低床和警报标志对预防跌倒很有用（bbb70 %）。对于将患者的助行器放置在触手可及的地方，人们的看法不一。提出的实际问题包括获得设备；低床使用的员工受伤风险。浴室监督被认为是有益的，但并不总是实用的。护士和高级工作人员对项目的适宜性和效益的看法是一致的。员工认为6-PACK计划是合适的、实用的和有益的，并愿意采用该计划。提出了一些实际的关切，突出了执行计划需要解决的问题。
There is limited evidence to support the effectiveness of falls prevention interventions in the acute hospital setting. The 6-PACK falls prevention program includes a fall-risk tool; 'falls alert' signs; supervision of patients in the bathroom; ensuring patients' walking aids are within reach; toileting regimes; low-low beds; and bed/chair alarms. This study explored the acceptability of the 6-PACK program from the perspective of nurses and senior staff prior to its implementation in a randomised controlled trial. A mixed-methods approach was applied involving 24 acute wards from six Australian hospitals. Participants were nurses working on participating wards and senior hospital staff including: Nurse Unit Managers; senior physicians; Directors of Nursing; and senior personnel involved in quality and safety or falls prevention. Information on program acceptability (suitability, practicality and benefits) was obtained by surveys, focus groups and interviews. Survey data were analysed descriptively, and focus group and interview data thematically. The survey response rate was 60%. Twelve focus groups (n = 96 nurses) and 24 interviews with senior staff were conducted. Falls were identified as a priority patient safety issue and nurses as key players in falls prevention. The 6-PACK program was perceived to offer practical benefits compared to current practice. Nurses agreed fall-risk tools, low-low beds and alert signs were useful for preventing falls (>70%). Views were mixed regarding positioning patients' walking aid within reach. Practical issues raised included access to equipment; and risk of staff injury with low-low bed use. Bathroom supervision was seen to be beneficial, however not always practical. Views on the program appropriateness and benefits were consistent across nurses and senior staff. Staff perceived the 6-PACK program as suitable, practical and beneficial, and were open to adopting the program. Some practical concerns were raised highlighting issues to be addressed by the implementation plan.