Abstract
Introduction
Falls are a global public health problem and the second leading cause of death from unintentional injury. Globally, approximately 30-50% of people living in nursing or residential care homes fall each year. Falls have an impact on quality of life and morbidity. Prevention of falls is gold standard care. When falls do occur implementation of safe strategies to help the person rise are required. Structured risk assessment and use of a ‘lifting’ cushion are one such strategy.
Aims
To evaluate the impact of the lifting cushion on management of falls and assess barriers and facilitators to staff use of the lifting cushion in 18 care homes.
Methods
Two phase study involving i) capturing quantitative pre and post cushion implementation data with comparison of means testing and ii) theoretically underpinned qualitative semi-structured interviews to explore barriers and facilitators to cushion implementation with inductive and deductive data analysis.
Results
The cushion was used a total of 32 times out of 567 post-implementation recorded falls (6% of all falls). Barriers and facilitators to cushion use aligned to the Theoretical Domains Framework included: knowledge, skills and confidence, emotion, beliefs about safety and decision processes, environmental context and resources and social influences.
Conclusion
The lifting cushion was poorly adopted. Identified barriers to adoption would not be addressed using routine train and cascade processes. We identified facilitators that could be enhanced to promote uptake. Theoretically underpinned implementation strategies, tailored to assessed determinants are known to be more effective, however this approach has rarely been used in care homes. We have demonstrated a structured approach to implementation of cushion use, this may be transferable to other care home practices.
Falls are a global public health problem and the second leading cause of death from unintentional injury. Globally, approximately 30-50% of people living in nursing or residential care homes fall each year. Falls have an impact on quality of life and morbidity. Prevention of falls is gold standard care. When falls do occur implementation of safe strategies to help the person rise are required. Structured risk assessment and use of a ‘lifting’ cushion are one such strategy.
Aims
To evaluate the impact of the lifting cushion on management of falls and assess barriers and facilitators to staff use of the lifting cushion in 18 care homes.
Methods
Two phase study involving i) capturing quantitative pre and post cushion implementation data with comparison of means testing and ii) theoretically underpinned qualitative semi-structured interviews to explore barriers and facilitators to cushion implementation with inductive and deductive data analysis.
Results
The cushion was used a total of 32 times out of 567 post-implementation recorded falls (6% of all falls). Barriers and facilitators to cushion use aligned to the Theoretical Domains Framework included: knowledge, skills and confidence, emotion, beliefs about safety and decision processes, environmental context and resources and social influences.
Conclusion
The lifting cushion was poorly adopted. Identified barriers to adoption would not be addressed using routine train and cascade processes. We identified facilitators that could be enhanced to promote uptake. Theoretically underpinned implementation strategies, tailored to assessed determinants are known to be more effective, however this approach has rarely been used in care homes. We have demonstrated a structured approach to implementation of cushion use, this may be transferable to other care home practices.
Original language | English |
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Journal | International Journal of Older People Nursing |
Publication status | Accepted/In press (AAM) - 16 Oct 2024 |