Participant flow through study.

<p>Participant flow through study.</p

Characteristics of participants at point of enrolment into study.

a<p>cataracts(untreated), macular degeneration, glaucoma.</p>b<p>transitional care facility, death.</p>c<p>Euro qol Dolan method, range −0.59 to 1.0 higher indicates better self-perceived health-related quality of life.</p>d<p>Euro qol visual analogue scale, range 0–100 higher indicates better self-perceived health-related quality of life.</p>e<p>Includes anti-psychotic, anti- depressant, mood stabilizing medication.</p

Falls outcomes after hospital discharge.

<p>Falls outcomes after hospital discharge.</p

Participants’ engagement in falls prevention strategies facilitated by education.

a<p>Adjusted for levels of engagement prior to intervention and length of time of observation after discharge.</p>b<p>Activities of daily living.</p>c<p>Assistance from family, friends or others.</p>d<p>Instrumental activities of daily living.</p>e<p>Includes program originally designed by health care professional or designed by participant themselves.</p>f<p>Includes program provided by health care professional either in the home, at a centre or outpatient setting.</p>g<p>Includes remove clutter, alter layout for easy access, use aids and appliances.</p

Participants’ perceptions (awareness, knowledge gain, confidence and motivation) of receiving education.

a<p>Three participants did not complete post education survey.</p>b<p>Likert scale where SA = strongly agree, A = agree, U = undecided, D = disagree, SD = strongly disagree.</p

Additional file 1: of Evaluating the impact of a falls prevention community of practice in a residential aged care setting: a realist approach

CoP member confidence, motivation and opportunity to engage in intranet usage and lead falls prevention activity. (DOCX 15 kb

Hospital Falls Clinical Practice Guidelines: A Global Analysis and Systematic Review

Background: Hospital falls continue to be a persistent global issue with serious harmful consequences for patients and health services. Many clinical practice guidelines now exist for hospital falls and there is a need to appraise recommendations.Method: A systematic review and critical appraisal of the global literature was conducted, compliant with PRISMA. Web of Science, Embase, CINAHL, MEDLINE, Epistemonikos, Infobase of Clinical Practice Guidelines, Cochrane CENTRAL, and PEDro databases were searched from 1 January 1993 to 1 February 2024. The quality of guidelines was assessed by two independent reviewers using AGREE GRS and AGREE-REX. Certainty of findings was rated using GRADE-CERQual. Data were analysed using thematic synthesis.Results: 2404 records were screened, 77 assessed for eligibility, and 20 hospital falls guidelines were included. Ten had high AGREE-REX quality scores. Key analytic themes were: (i) there was mixed support for falls risk screening at hospital admission, but scored screening tools were no longer recommended; (ii) comprehensive falls assessment was recommended for older or frail patients; (iii) single and multifactorial falls interventions were consistently recommended; (iv) a large gap existed in patient engagement in guideline development and implementation; (v) barriers to implementation included ambiguities in how staff and patient falls education should be conducted, how delirium and dementia are managed to prevent falls, and documentation of hospital falls.Conclusion: Evidence-based hospital falls guidelines are now available, yet systematic implementation across the hospital sector is more limited. There is a need to ensure an integrated and consistent approach to evidence-based falls prevention for a diverse range of hospital patients.</p

Reducing falls after hospital discharge: a protocol for a randomised controlled trial evaluating an individualised multimodal falls education programme for older adults

Introduction: Older adults frequently fall after discharge from hospital. Older people may have low self-perceived risk of falls and poor knowledge about falls prevention. The primary aim of the study is to evaluate the effect of providing tailored falls prevention education in addition to usual care on falls rates in older people after discharge from hospital compared to providing a social intervention in addition to usual care. Methods and analyses: The Back to My Best study is a multisite, single blind, parallel-group randomized controlled trial with blinded outcome assessment and intention-to-treat analysis, adhering to CONSORT guidelines. Patients (n=390) (aged 60 years or older; score more than 7/10 on the Abbreviated Mental Test Score; discharged to community settings) from aged care rehabilitation wards in three hospitals will be recruited and randomly assigned to one of two groups. Participants allocated to the control group shall receive usual care plus a social visit. Participants allocated to the experimental group shall receive usual care and a falls prevention programme incorporating a video, workbook and individualised follow-up from an expert health professional to foster capability and motivation to engage in falls prevention strategies. The primary outcome is falls rates in the first 6 months after discharge, analysed using negative binomial regression with adjustment for participants length of observation in the study. Secondary outcomes are injurious falls rates, the proportion of people who become fallers, functional status and health-related quality of life. Healthcare resource use will be captured from four sources for 6 months after discharge. The study is powered to detect a 30% relative reduction in the rate of falls (negative binomial incidence ratio 0.70) for a control rate of 0.80 falls per person over 6 months. Ethics and dissemination: Results will be presented in peer-reviewed journals and at conferences worldwide. This study is approved by hospital and university Human Research Ethics Committees