Falling short on implementation of fall prevention guidelines in health services: a systematic review with meta-analysis.
Background Falls are a serious risk for people who use health services. We aimed to evaluate the implementation of fall prevention guidelines in health services. Methods Databases and grey literature were searched for studies of the implementation of fall prevention guidelines in health services. Im...
| Publicado en: | Age & Ageing Vol. 54; no. 10; pp. 1 - 12 |
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| Autores principales: | , , , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Oct2025
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=189289180&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 189289180 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Oct2025 vid: 54 iid: 10 pid: 622 pub: Oxford University Press / USA artinfo: ui: 189289180 10.1093/ageing/afaf307 ppf: 1 ppct: 11 formats: tig: atl: Falling short on implementation of fall prevention guidelines in health services: a systematic review with meta-analysis. aug: au: Haley, Melanie N Sherrington, Catherine Lawler, Katherine Harding, Katherine E Lord, Margaret Williams, Stuart Taylor, Nicholas F affil: School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia Physiotherapy, Eastern Health, Box Hill, Victoria, Australia Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia Sydney Local Health District, Institute for Musculoskeletal Health, Sydney, New South Wales, Australia Allied Health Clinical Research Office, Eastern Health, Box Hill, Victoria, Australia Consumer Partner, Melbourne, Victoria, Australia su: Patient compliance Human services programs Interprofessional relations Patient safety Medical care Evaluation of medical care Patient-professional relations Health behavior Continuing education Medical protocols Medical information storage & retrieval systems Research funding CINAHL database Meta-analysis Descriptive statistics Systematic reviews MEDLINE Medical databases Attitudes of medical personnel Online information services Confidence intervals Quality assurance Accidental falls Sensitivity & specificity (Statistics) sug: subj: Patient compliance Human services programs Interprofessional relations Patient safety Medical care Evaluation of medical care Patient-professional relations Health behavior Continuing education Professional and Management Development Training Medical protocols Medical information storage & retrieval systems Research funding CINAHL database Meta-analysis Descriptive statistics Systematic reviews MEDLINE Medical databases Attitudes of medical personnel Online information services Confidence intervals Quality assurance Accidental falls Sensitivity & specificity (Statistics) keyword: elderly falls guidelines fall prevention falls gray literature guideline guidelines health personnel health services healthcare hospital implementation internal validity older adult older people systematic review elderly falls guidelines fall prevention falls gray literature guideline guidelines health personnel health services healthcare hospital implementation internal validity older adult older people systematic review ab: Background Falls are a serious risk for people who use health services. We aimed to evaluate the implementation of fall prevention guidelines in health services. Methods Databases and grey literature were searched for studies of the implementation of fall prevention guidelines in health services. Implementation outcomes were aligned with the reach, effectiveness, adoption, implementation and maintenance framework. The methodological quality of included papers was assessed using an internal validity checklist. Results were synthesised using narrative synthesis and meta-analysis. The certainty of evidence of each meta-analysis was assessed using the Grading of Recommendations Assessment, Development and Evaluation framework. Results Fifty-five studies of over 115 000 patients implemented recommendations from 14 fall prevention guidelines. Methodological quality was generally poor (median of 5 of 13 internal validity criteria). Median reach of guideline implementation was 64% (range 38%−96%, five studies). Meta-analysis provided low certainty evidence that implementing guidelines did not prevent falls [falls risk ratio 1.01, 95% confidence interval (CI) = 0.81–1.26; falls rate ratio 1.06, 95% CI = 0.77–1.46]. Adoption of fall prevention recommendations by health professionals improved in 87% of recorded outcomes across 43 studies and was maintained 50% of the time. Adherence of patients to recommendations, however, varied from 7% to 73%. Two studies assessed maintenance of reduced falls percentage or rates and found that changes were sustained. Conclusion Implementation of fall prevention guidelines in health services can change and sometimes sustain fall prevention behaviour of health professionals. It is uncertain whether implementation leads to reduced falls or changes in patient behaviour. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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