Falls risk assessment and prevention
Research type
Research Study
Full title
Practices of falls risk assessment and prevention in acute hospital settings: A realist investigation
IRAS ID
284371
Contact name
Rebecca Randell
Contact email
Sponsor organisation
University of Bradford
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Background: Falls are the most common type of safety incident reported by acute hospitals, and can cause both physical (e.g. hip fractures) and non-physical harm (e.g. reduced confidence) to patients. The National Institute for Health and Care Excellence (NICE) guideline on falls in older people recommends that, in order to prevent falls in hospital, patients should receive a multifactorial falls risk assessment and be provided with a multifactorial intervention, tailored to address the patient’s identified individual risk factors. It is estimated that such an approach could reduce the incidence of inpatient falls by 25-30% and reduce the annual cost of falls by up to 25%. However, there is substantial unexplained variation between hospitals in adherence to the NICE guideline, in terms of levels of assessments and interventions. \nAim: To determine how and in what contexts multifactorial falls risk assessment and tailored multifactorial falls prevention interventions are used as intended on a routine basis in acute hospitals in the NHS in England. \nMethods: Realist evaluation, which is concerned with understanding for whom and in what circumstances complex interventions work and involves building, testing and refining the theories of how the intervention is supposed to work, provides an overall framework for the study. Our project is comprised of three work packages (WPs):\nWP1: A realist review of the literature will be undertaken. We will first identify theories concerning how and in what contexts multifactorial falls risk assessment and the implementation of tailored falls prevention interventions lead to a reduction in patients’ falls risk. We will then test these theories systematically, using primary studies to determine whether empirical evidence supports, refutes, or suggests a revision or addition to the identified theories. As part of testing the theories, we will assess acute hospital Trust policies for adherence to the NICE guideline, to provide insight into whether the level of adherence reflects decisions made at the organisational level. \nWP2: To further refine the theories, we will undertake a multi-site case study across three acute hospital Trusts, gathering data through ethnographic observation, interviews with staff and patients, and review of patient records and other documents.\nWP3: We will translate the findings into actionable guidance that Trusts can use to inform their own falls risk assessment and prevention strategies.
REC name
Yorkshire & The Humber - Bradford Leeds Research Ethics Committee
REC reference
20/YH/0221
Date of REC Opinion
9 Sep 2020
REC opinion
Favourable Opinion