Barriers to Research Barriers to Research UtilizationUtilization

Team ATeam AStacy Coleman

Stephanie McLeodAimee Rivas

Christine SchultzDebbie Wilson

Introduction To Patient FallsIntroduction To Patient Falls• Highest incidence in people 65 & older

– Leading cause of injury deaths– Most common cause of hospital admissions for trauma– Rates for LTC residents 3 times higher then aged living at

home– 25% to 84% of incident reports in hospitals and LTC facilities

are related to falls

• Nurses are responsible – For patient safety & fall prevention

Patient FallsPatient Falls• What’s Considered a Patient Fall?

– Any unplanned descent to the floor– Includes when patient lowered to floor to prevent falls, or

lowers himself/herself to floor

• Types & Causes of Falls – Accidental Falls– Unanticipated Physiological Falls– Anticipated Physiological Falls– Intrinsic and extrinsic factors

Cultural Barriers in Patients

• Age

• Authority

• Sex

• Fear

 Strategies for preventing falls

• Identify

• Fall assessment

• Alerting the staff

• Fall Research

Motor Control and Adaptive Training

• Motor Control• Learning Adaptive

Training• Weight Support• Stability• Retention

Calcium & Vitamin D Therapy & Fall Reduction Strategy

• Age Related Changes 

• Vitamin D 

• Calcium 

• Fall Prevention through Combination Therapy   

Barriers & The Team• Demonstrating the Relationship

– The decision maker– Relationship development – Building mutual trust– Sharing responsibilities

• Determining the Structure – Roles and responsibility of the researcher/s – Establishing communication guidelines– Development of a steering committee &

working committee

• Organizational climate– Organization experience with research – Creating credibility– Availability (i.e. staffing)

Leadership Barriers• Presenting The Research

– Creative Problem solving – Balance – Previous Study Reviews

• OrganizingThe Research Study– Assembling the risk factors – Instrumentation methods– Recommendations– Interventions– Study impact

• Conformity With The Team • On indicators & outcomes• On teaching methods• On evaluation

Organizational Culture Barriers

• What is Organizational Culture?

• Identification of Organizational Barriers– “Sitters” & Attendants– Staffing

• Integration & Partnerships

Conclusion

• “Among people 65 years and older, falls are the leading cause of injury deaths and the most

common cause of nonfatal injuries and hospital admissions for trauma.”*

• Patient falls are one of the top five sentinel events for hospitals, long term care, and home care

agencies…”***(Quigley et al.,2008, as reported in CDC, 2006).

**(Quigley et al.)

ReferencesReferencesBoonen, S., Bischoff-Ferrari, H., Cooper, C., Lips, P., Ljunggren, O., Meunier, P.,

Reginster, J.-Y., (2006). Addressing the musculoskeletal components of fracture risk with Calcium and Vitamin D: A review of the evidence.. Calcified Tissue International, 78(11), 257-270

Center for Disease Control. Studies of AoA-funded Fall Prevention Programs (2008).Retreived June 10, 2008 from http://www.cdc.gov/ncipc/duip/FallsPreventionActivity.htm#research%20studies

Comprehensive Fall Prevention. Planning for Success in Identifying and Referring Older Adults through Hospital- Based programs. (2004). Retrieved June 10, 2008 from http://mphi.org/files/Fall%20Prevention%20for%20Community%20Dwelling%20Older%20Adults%202004.pdf

McNamara, C. (1997). Organizational culture: what is culture? Retrieved June 12, 2008, from http://www.managementhelp.org/org_thry/culture/culture.htm

National Defense University. (n.d.). Strategic leadership and decision making organizational culture. Retrieved June 13, 2008, from http://www.au.af.mil/au/awc/awcgate/ndu/strat-ldr-dm/pt4ch16.html

ReferencesReferencesNational Institutes of Health: Osteoporosis and Related Bone Diseases National

Resource Center. Falls and Related Fractures: The risk of undiagnosed Osteoporosis. April 2000.

Pai, Y-C. Bhatt, T (2007). Repeated-slip training: An emerging paradigm for prevention of slip -related falls among older adults. Physical Therapy.87(11) 1478-1494

PubMed. Design-related bias in hospital fall risk screening tool predictive accuracy evaluations: systematic review and meta-analysis. (2007) Retrieved June 10, 2008 from http://www.ncbi.nlm.nih.gov/pubmed/17595425

Premier, Inc. (2008). Fall prevention. Retrieved June 14, 2008, from http://www.premiereinc.com/saftey/topics/falls/#top

Quigley, P., Nelly, J., Watson, M., Wright, M. & Strobel, K. (2007). Measuring fall program outcomes. The Online Journal of Issues in Nursing. Retrieved June 10, 2008, from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodic

ReferencesReferencesRehab Management. Reducing the Risk of Falls in the Elderly. (2000) Retrieved Jun

10, 2008 from http://www.rehabpub.com/features/672000/4.aspScott, V. (2007, April). World health organization report: prevention of falls in older

age. Retrieved May 13, 2008, from http://www.who.int/ageing/projects/5.Intervention,%20policies%20and%20sustainability%20of%20falls%20prevention.pdf

St. Joseph’s/Candler (2008). Falls prevention education module. Retrieved June 14,2008 from https://.netapp.netlkearning/learnmod/stjosephcandler/fallprevent/sld004.htm

Toolpack Consulting. (2008). Organizational culture. Retrieved June 13, 2008, from http://www.toolpack.com/culture.html

Torkelson, D., & Dobal, M. (1999, May). Constant observation in medical-surgical settings: a multi hospital study. Retrieved June 13, 2008, from http://www.findarticles.com/p/articles/mi_m0FSW/is_3_17/ai_n18608643/pg_7

ReferencesReferencesToolpack Consulting. (2008). Organizational culture. Retrieved June 13, 2008, from

http://www.toolpack.com/culture.htmlTorkelson, D., & Dobal, M. (1999, May). Constant observation in medical-surgical

settings: a multi hospital study. Retrieved June 13, 2008, from http://www.findarticles.com/p/articles/mi_m0FSW/is_3_17/ai_n18608643/pg_7