Greet Leysens

Characteristics and Effectiveness of Fall Prevention Programs in Nursing Homes: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

To determine characteristics and effectiveness of prevention programs on fall‐related outcomes in a defined setting.

Implementation of fall prevention in residential care facilities: A systematic review of barriers and facilitators

OBJECTIVES To identify the barriers and facilitators for fall prevention implementation in residential care facilities. DESIGN Systematic review. Review registration number on PROSPERO: CRD42013004655. DATA SOURCES Two independent reviewers systematically searched five databases (i.e. MEDLINE, EMBASE, CINAHL, PsycINFO, and Web of Science) and the reference lists of relevant articles. REVIEW METHODS This systematic review was conducted in line with the Center for Reviews and Dissemination Handbook and reported according to the PRISMA guideline. Only original research focusing on determinants of fall prevention implementation in residential care facilities was included. We used the Mixed Method Appraisal Tool for quality appraisal. Thematic analysis was performed for qualitative data; quantitative data were analyzed descriptively. To synthesize the results, we used the framework of Grol and colleagues that describes six healthcare levels wherein implementation barriers and facilitators can be identified. RESULTS We found eight relevant studies, identifying 44 determinants that influence implementation. Of these, 17 were facilitators and 27 were barriers. Results indicated that the social and organizational levels have the greatest number of influencing factors (9 and 14, respectively), whereas resident and economical/political levels have the least (3 and 4, respectively). The most cited facilitators were good communication and facility equipment availability, while staff feeling overwhelmed, helpless, frustrated and concerned about their ability to control fall management, staffing issues, limited knowledge and skills (i.e., general clinical skill deficiencies, poor fall management skills or lack of computer skills); and poor communication were the most cited barriers. CONCLUSION Successful implementation of fall prevention depends on many factors across different healthcare levels. The focus of implementation interventions, however, should be on modifiable barriers and facilitators such as communication, knowledge, and skills. Effective fall prevention must consist of multifactorial interventions that target each residents fall risk profile, and should be tailored to overcome context-specific barriers and put into action the identified facilitators.

On-site electronic observational assessment tool for discomfort and pain

Over the recent years pen-paper observational assessment scales have proven to be useful to monitor behaviour and responses of humans and animals. Observational assessment tools are typically applied for subjects who are not able to communicate directly. For on-site observational assessment however it is hard to record and evaluate timing patterns of observed events using pen-paper scales. Although timing information is in many cases assumed highly valuable, only (videotaped) laboratory scales are able to benefit from this knowledge. In the work described in this paper we digitize pen-paper assessment scales resulting in new functionalities capable to improve assessment scores. A study of on-site pain and discomfort assessment of severely demented elderly is presented. The resulting system is a mobile electronic device with a graphical user interface (GUI) on a touch screen. Moreover digital information is stored in a database improving administration, providing immediate feedback and allowing applications like: visualisation, statistical analysis and scientific research like data mining. The device allows easily registering and automatically interpreting complex timing patterns of behaviours and responses, on-site. This feature could be employed in the development of new more accurate observational assessment instruments.

P-339: The use of fall prevention strategies in home care: a survey in Flanders (Belgium)

a Center of Expertise for Fall and Fracture Prevention Flanders, Belgium b Department of Public Health and Primary Care, Health Services and Nursing Research, KU Leuven, Leuven, Belgium c Division of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium d Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium e Unit for Osteoporosis and Metabolic Bone Disease, Department of Rheumatology and Endocrinology, Ghent University Hospital, Ghent, Belgium f Domus Medica, Society of Flemish General Practitioners, Antwerp, Belgium