Delaforce Alana, Li Jane, Niven Philippa, Maddock Emma, Grujovski Melisa, Fahy Michael J, Good Norman M, Jayasena Rajiv
Australian E-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Herston, QLD, Australia.
Nursing and Midwifery Services, Maitland Hospital, Hunter New England Local Health District, Maitland, NSW, Australia.
J Multidiscip Healthc. 2025 Jun 17;18:3507-3518. doi: 10.2147/JMDH.S529247. eCollection 2025.
Falls are a major cause of hospital acquired complications and inpatient harm. Interventions to prevent falls exist, but it is unclear which are most effective and what implementation strategies best support their use. This study sought to ascertain the impact of a co-designed implementation enhancement plan on the adoption and effect of a digital fall prevention platform in a new hospital.
A non-randomized pre-post interventional study using multi-methods. A bespoke survey as well as descriptive and inferential statistical analysis of hospital administrative data and were used to identify the impact on: (1) adoption of the system and (2) the rate of falls.
The co-design implementation enhancement plan successfully improved the adoption of some key platform functions, most importantly, a 39% increase ( = 0.04) in setting a patient as having a high risk of falling on the staff station console. There were also improvements in staff response times, satisfaction and perceptions of the fall prevention platform. A risk reduction in falls per 1000 bed days was observed among cognitively intact patients post implementation enhancement plan, however, this difference was not statistically significant (OR = 0.97 95% CI [0.78,1.22] = 0.77).
The co-designed implementation enhancement plan improved uptake of the platform and is likely to be effective for other similar interventions. The platform shows the potential to reduce falls among cognitively intact patients, but longer periods of observation and a larger sample are needed to confirm the effect. Aside from falls, a reduction in nurse response time is likely to improve patient care and experience.
跌倒是非故意伤害和住院患者并发症的主要原因。虽然存在预防跌倒的干预措施,但尚不清楚哪些措施最为有效,以及哪些实施策略能最有力地支持这些措施的应用。本研究旨在确定一项共同设计的实施强化计划对一家新建医院采用数字防跌倒平台及其效果的影响。
采用多方法进行非随机前后对照干预研究。通过定制调查以及对医院管理数据进行描述性和推断性统计分析,以确定对以下方面的影响:(1)系统的采用情况;(2)跌倒发生率。
共同设计的实施强化计划成功提高了一些关键平台功能的采用率,最重要的是,在员工工作站控制台将患者设定为跌倒高风险的比例增加了39%(P = 0.04)。员工响应时间、对防跌倒平台的满意度和认知度也有所改善。实施强化计划后,认知功能正常的患者每1000床日的跌倒风险有所降低,但差异无统计学意义(OR = 0.97,95%CI [0.78,1.22],P = 0.77)。
共同设计的实施强化计划提高了平台的使用率,可能对其他类似干预措施也有效。该平台显示出降低认知功能正常患者跌倒风险的潜力,但需要更长时间的观察和更大的样本量来证实其效果。除了跌倒,护士响应时间的缩短可能会改善患者护理和体验。