Background
Methods
Design
Participants and setting
Outcome measures
Data collection and procedure
CoP member level
RAC facility level
RAC organisation level
Data analysis
Member level
Facility level
Organisation level
Identification of causal mechanisms
Results
Impact at member level | Impact at facility level | Impact at organisation level |
---|---|---|
Increased falls prevention knowledge | Annual evidenced-based falls prevention activity audit with intermittent spot checks | Falls policy (re-written and implemented) |
Increased self-reported confidence and motivation to engage in falls prevention actions | Increased proportion of residents supplemented with vitamin D at all sites | Standardised fall definition adopted |
Increased connections and collaborations with interdisciplinary CoP members | Falls prevention CoP listed as agenda item at facility staff meetings | New falls risk assessment tool placed in online assessment system |
Falls prevention committee formed | Aligned falls prevention management plan (developed and implemented) | |
Falls prevention checklists for individual residents at highest risk of falling (“catch a falling star” program) | CoP newsletter (developed and implemented) 4 editions published | |
Surveyed frontline care staff and residents to determine falls prevention education needs and preferences | Falls prevention CoP listed as agenda item at RAC Board Committee meetings | |
Surveyed care managers to determine their perception of CoP impact at their site | ||
Falls prevention poster checklist for staff and residents | ||
Screening for safer resident footwear, clothing and lighting (night time sensor lights) |
Member level impact
Capability, opportunity and motivation to prevent falls
Connectivity amongst the membership
Facility level impact
Evidence-based falls prevention audit
Vitamin D supplementation
Falls prevention education
Falls meetings, screening personal items and equipment provision
Barriers to implementation
Organisation level impact.
Falls prevention policy and processes
Dissemination of CoP actions
Barriers to evidence translation
What worked? for whom? and under what conditions?
Member Level | |
CCMO 1 | Members who demonstrated higher levels of falls prevention knowledge and awareness (psychological capability) and felt they needed to action fall prevention strategies enough (reflective motivation), better engaged with other site staff to enable implementation of falls prevention strategies |
CCMO 2 | Members who participated more in CoP social learning opportunities, connected to experts, gained confidence and credibility and were motivated to make a greater contribution to falls prevention change at their facility |
CCMO 3 | Membership of a CoP enabled new and more frequent interdisciplinary connections to develop serving as a resource for guidance and reduced professional isolation within the organisation, when time to participate was supported by facility managers |
RAC facility level | |
CCMO 4 | Facility visiting GPs who related to RAC staff (particularly CoP members and Nurse Practitioners) as credible peers and advocated for the recommended evidence significantly improved their proportion of residents supplemented with vitamin D |
CCMO 5 | Falls prevention programs were best implemented and adopted by frontline staff when the resident’s prevention strategies were prompted in novel ways and documentation of strategy enactment was made accountable by care managers |
CCMO 6 | Higher levels of care manager support, through realisation and prioritisation for staff to participate as CoP members and action falls prevention at their facility, enabled the implementation of evidence based practices |
RAC organisation level | |
CCMO 7 | Organisational acknowledgment of gaps in governance and recognition of the consequences of not taking a more preventative approach (reflective motivation) regarding falls management changed the cultural focus towards pro-action, following greater engagement with the CoP |
CCMO 8 | Failure to offer opportunity in terms of dedicated time commitment for CoP members to learn and engage in falls prevention activity above existing professional duties, limited implementation of falls prevention activities |
CCMO 9 | Receiving regular reports on the CoP’s falls prevention actions created a stronger feedback loop from frontline care to general management and assisted in focussing attention on falls prevention |