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Barriers and enablers to the implementation of the 6-PACK falls prevention program: a pre-implementation study in hospitals participating in a cluster randomised controlled trial

Ayton, Darshini R., Barker, Anna L., Morello, Renata T., Brand, Caroline A., Talevski, Jason, Landgren, Fiona S., Melhem, Mayer M., Bian, Evelyn, Brauer, Sandra G., Hill, Keith D., Livingston, Patricia M. and Botti, Mari 2017, Barriers and enablers to the implementation of the 6-PACK falls prevention program: a pre-implementation study in hospitals participating in a cluster randomised controlled trial, PLoS one, vol. 12, no. 2, pp. 1-13, doi: 10.1371/journal.pone.0171932.

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Title Barriers and enablers to the implementation of the 6-PACK falls prevention program: a pre-implementation study in hospitals participating in a cluster randomised controlled trial
Author(s) Ayton, Darshini R.
Barker, Anna L.
Morello, Renata T.
Brand, Caroline A.
Talevski, Jason
Landgren, Fiona S.
Melhem, Mayer M.
Bian, Evelyn
Brauer, Sandra G.
Hill, Keith D.
Livingston, Patricia M.
Botti, Mari
Journal name PLoS one
Volume number 12
Issue number 2
Article ID e0171932
Start page 1
End page 13
Total pages 13
Publisher Public Library of Science
Place of publication San Francisco, Calif.
Publication date 2017
ISSN 1932-6203
Keyword(s) Science & Technology
Multidisciplinary Sciences
Science & Technology - Other Topics
ACUTE-CARE HOSPITALS
INJURIES
SINGAPORE
PROTOCOL
Summary Evidence for effective falls prevention interventions in acute wards is limited. One reason for this may be suboptimal program implementation. This study aimed to identify perceived barriers and enablers of the implementation of the 6-PACK falls prevention program to inform the implementation in a randomised controlled trial. Strategies to optimise successful implementation of 6-PACK were also sought. A mixed-methods approach was applied in 24 acute wards from 6 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 barriers and enablers of 6-PACK implementation was obtained through surveys, focus groups and interviews. Questions reflected the COM-B framework that includes three behaviour change constructs of: capability, opportunity and motivation. Focus group and interview data were analysed thematically, and survey data descriptively. The survey response rate was 60% (420/702), and 12 focus groups (n = 96 nurses) and 24 interviews with senior staff were conducted. Capability barriers included beliefs that falls could not be prevented; and limited knowledge on falls prevention in patients with complex care needs (e.g. cognitive impairment). Capability enablers included education and training, particularly face to face case study based approaches. Lack of resources was identified as an opportunity barrier. Leadership, champions and using data to drive practice change were recognised as opportunity enablers. Motivation barriers included complacency and lack of ownership in falls prevention efforts. Motivation enablers included senior staff articulating clear goals and a commitment to falls prevention; and use of reminders, audits and feedback. The information gained from this study suggests that regular practical face-to-face education and training for nurses; provision of equipment; audit, reminders and feedback; leadership and champions; and the provision of falls data is key to successful falls prevention program implementation in acute hospitals.
Language eng
DOI 10.1371/journal.pone.0171932
Field of Research 111099 Nursing not elsewhere classified
MD Multidisciplinary
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2017, The Authors
Free to Read? Yes
Use Rights Public Domain Mark
Persistent URL http://hdl.handle.net/10536/DRO/DU:30092825

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.