P27: From Development to Implementation: A Novel Clinical Post-Fall Assessment Tool in Long-Term Care

Abstract

Objectives: The study aims to: (i) develop a clinical post-fall assessment tool for older adults in long-term care (LTC) settings; (ii) validate the tool’s effectiveness and usability; and (iii) assess the practical application and impact of the tool within LTC units.

Methods: The three-phase study employed a sequential exploratory mixed-Methods framework. Phase I: Tool development comprised a comprehensive literature review and a qualitative study of semi-structured interviews with nine healthcare professionals. Phase II: Validation adopted an embedded design, where qualitative perceptions from 18 professionals through two focus groups informed iterative improvements and a quantitative questionnaire (a Likert scale and open-ended questions) assessed the tool’s effectiveness and user experience. Phase III: Implementation encompassed a retrospective and prospective longitudinal study, focusing on fall incidence, communication efficacy, and usability, to gauge the tool’s real-world impact.

Results: From Phase I, a mnemonic checklist was developed and structured into five sections: patient characteristics, fall description, primary and secondary assessments, and post-fall management—selected for clinical practicality. In Phase II, focus group insights prompted refinements to the tool, while follow-up questionnaires indicated the tool’s substantial utility in enhancing practice (65%), communication (69%), usability (71%), and satisfaction (76%). Responses highlighted key challenges such as resistance to change and workload, contrasting with facilitators like availability and uniformity. The need for training and a period of adaptation were viewed as factors that could compromise use. In Phase III, the tool showed greater utility for identifying fall-related complications and managing falls, with a notable preference among all nurses, regardless of experience level, particularly those with less than 5 years of experience.

Moreover, a comparison of falls over two three-month periods—one without the tool and one with it—revealed that the tool enhanced communication between doctors and nurses. This improvement led to quicker notification of doctors and more efficient transfers of patients to the emergency room when necessary.

Conclusions: Our tool aims to improve comprehensive post-fall assessments for older adults in LTC settings, facilitating improved communication and decision-making among healthcare professionals. With its usability and practical design, this mnemonic checklist shows great potential for wide adoption in enhancing patient care practices.