Parekh Abhishek, Hill Keith D, Guerbaai Raphaëlle Ashley
Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Frankston, Australia.
Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Frankston, Australia.
J Clin Nurs. 2025 Feb;34(2):408-421. doi: 10.1111/jocn.17546. Epub 2024 Nov 18.
The population is rapidly growing, significantly impacting healthcare settings such as hospitals and long-term care. Falls are a major concern, being a leading cause of hospitalisations and injuries especially among adults aged 60 and above. Despite extensive research on falls prevention and risk factors, there is limited study on effective post-fall management strategies, making it crucial to review and develop interventions to improve care and safety for older adults in healthcare settings.
To explore the interventions implemented for post-fall management for residents and patients within healthcare settings, including hospitals and long-term care facilities.
A scoping literature review.
We used the Joanna Briggs Institute guidance and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews (PRISMA-ScR). Eligible articles included hospital and long-term care post-fall management interventions. Data were manually extracted by two independent reviewers using the AACTT (Actor, Action, Context, Target and Time) Framework to detail intervention characteristics and guide the data charting process, allowing for thematic analysis and narrative synthesis of key findings.
Medline, CINAHL, PsychINFO and Scopus were searched from inception until 30th September 2024.
Eighteen articles were included. Over half the studies (55.5%) focused on post-fall interventions in LTCFs, testing assessment tools (50%), structured protocols (27.7%), huddles (11.1%) or multifactorial approaches (11.1%), with varied effectiveness. While assessment tools and huddles showed mixed results, structured protocols showed encouraging results with reduced unnecessary hospital transfers and hospitalisations.
This scoping review identified a variety of interventions used after falls in healthcare settings. However, there is inconclusive evidence about the effectiveness of interventions to reduce hospitalisation and injuries. This review identified areas for research that may help to inform post-fall management, including the need for further research into various interventions (e.g., standardised toolkit) to enhance care immediately following a fall.
No Patient or Public Contribution.
人口正在迅速增长,对医院和长期护理等医疗环境产生了重大影响。跌倒令人十分担忧,是住院和受伤的主要原因,尤其是在60岁及以上的成年人中。尽管对跌倒预防和风险因素进行了广泛研究,但关于有效的跌倒后管理策略的研究却很有限,因此有必要审查和制定干预措施,以改善医疗环境中老年人的护理和安全。
探讨在包括医院和长期护理机构在内的医疗环境中,针对居民和患者实施的跌倒后管理干预措施。
一项范围综述。
我们使用了乔安娜·布里格斯研究所的指南以及系统评价和Meta分析扩展版的首选报告项目(PRISMA-ScR)进行范围综述。符合条件的文章包括医院和长期护理机构的跌倒后管理干预措施。由两名独立评审员使用AACTT(行为者、行动、背景、目标和时间)框架手动提取数据,以详细说明干预措施的特征并指导数据图表绘制过程,从而进行主题分析和关键发现的叙述性综合。
检索了Medline、CINAHL、PsychINFO和Scopus数据库,检索时间从建库至2024年9月30日。
纳入了18篇文章。超过一半的研究(55.5%)关注长期护理机构中的跌倒后干预措施,测试评估工具(50%)、结构化方案(27.7%)、小组讨论(11.1%)或多因素方法(11.1%),效果各不相同。虽然评估工具和小组讨论结果不一,但结构化方案显示出令人鼓舞的结果,减少了不必要的医院转诊和住院。
这项范围综述确定了医疗环境中跌倒后使用的多种干预措施。然而,关于减少住院和受伤的干预措施的有效性,证据并不确凿。本综述确定了可能有助于为跌倒后管理提供信息的研究领域,包括需要进一步研究各种干预措施(如标准化工具包),以在跌倒后立即加强护理。
无患者或公众参与。