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Adams SL. Reducing Falls and Fall-related Injuries in Hospitalized Veterans. Poster session presented at: Midwest Nursing Research Society Annual Conference; 2012 Apr 13; Dearborn, MI.
Background: Inpatient falls are a major concern due to their frequency and the severity of their consequences. Using the PARIHS framework, external facilitation was proposed to overcome internal contextual barriers to implementation of EBP interventions across three VA facilities. Objectives: The primary objective was to examine the feasibility of using a facilitated nursing collaborative to implement evidence-based falls prevention interventions. Aim 1: Identify staff nurses' perceived contextual barriers and/or facilitators to the implementation of an evidence-based falls prevention program. Aim 2: Evaluate the effect of facilitated collaboration on the nurses' ability to overcome contextual barriers and leverage identified facilitators to successfully implement an evidence-based falls prevention program. Aim 3: Evaluate nurses' perception of which elements of the collaboration and facilitation were helpful in implementing the falls prevention program. Aim 4: Estimate the effect size of the falls prevention intervention program on fall rates and fall injury rates in the selected units. Methods: This 12-month study used a participatory action research design. Nurses from three VA facilities worked together in facilitated collaboration to select tailored interventions to implement on two medical units in each facility. The collaboration model included: 1) monthly group phone conferences; 2) monthly site consultation calls; 3) monthly educational webinar sessions and 4) an on-site visit by the project facilitation team. Study data included formative evaluation field notes, summative focus groups, and monthly rates of falls and fall-related injuries on participating units. Results: Analysis shows improvement in trend lines of fall rates in five of the six medical units. Analysis of focus group data indicates overall positive evaluation of both the facilitation and the collaboration. Conclusion: Results indicate use of a facilitated nursing collaborative presents a potential method to share resources, overcome barriers and improve patient care.