1. Effectiveness of Fall Prevention Intervention Programmes in Nursing Practice
- Author
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HOROVÁ, Jana
- Subjects
efektivita ,education ,patient ,pád ,následky pádu ,vzdělávání ,preventivní program ,prevention programme ,fall ,e-learning ,effectiveness ,fall consequences ,pacient - Abstract
Patient falls and fall injuries have become one of the most common adverse events reported by health care providers due to all the circumstances associated with hospitalisation.Worldwide preventive actions in the field of patient falls focus on soft factors,predominantly on the education of healthcare professionals and patients,and organisational culture.Due to the dynamic development of information technologies and the increasing digital literacy of the professional and lay population,the e-learning field is an increasingly sought-after form of education.The empirical part's main objective was to determine the effectiveness of general nurses' education through information technology as an intervention programme to prevent patient falls. The main objective was divided into consecutive partial objectives.A mixed approach was used.The study uses a observational-interventional design. The first partial objective,an analysis of patient falls, was investigated using a quantitative research method.Patient falls concerning a major health care provider were analysed over five years.The ??2-test or Fisher's exact test was used to test statistical relations.The Kruskal-Wallis test was used to test nonparametric variables.Regression analysis was applied to evaluate the trend in the incidence of fall injuries with regard to high-risk patients.The second research phase was based on the previous phase results,whereby a qualitative methodological approach was selected.The aim was to detect areas of falls focused on the specifics of the clinical environment,which were suitable for being included in the educational programme.Data was collected through a semi-structured interview. The third partial objective was creating and implementing an e-learning educational programme for general nurses in a clinical environment.Within the pilot testing,the properties of knowledge tests,content validity,and reliability were verified using Spearman's rank correlation coefficient and Cronbach's alpha.The effectiveness of the established e-learning programme (fourth partial objective)was verified by comparing the incidence of patient falls before and after the established intervention.Bonferroni correction and test of equality of parameters of two alternative distributions were used to verify the homogeneity of the compared groups of patients. With regard to the possible influence of confounders and to verify the incidence of injuries caused by falls,the method of statistical matching (propensity score matching) was subsequently used.Valuation of the e-learning programme's effectiveness with regard to the participants' level of knowledge was performed by comparing the results of the input and output knowledge test,for which the Stuart-Maxwell test and Fisher's exact test were used.The analysis of partial objectives of individual research phases was carried out separately;the objectives logically followed,and fulfilling the previous objective conditioned their fulfilment.The test of equality of parameters of two alternative distributions allowed for comparing groups of patients that could be considered equal.There was a decrease in the incidence of patient injuries due to falls in both disciplines (all injuries in the surgical discipline; p ? 0.05 and severe injuries in the internal medicine discipline; p ? 0.01).The results proved the influence of the e-learning educational programme on specific clinical practice indicators.Statistical matching eliminated confounding factors and confirmed a statistically significant reduction in the incidence of falls in patients with internal medicine injuries (p? 0,05).There was also an improvement in the participants' knowledge in the output knowledge test (p ? 0,001). Education of medical personnel based on the principles of science and the needs of clinical practice is a possible effective preventive intervention in patients falls and efforts to minimise the occurrence their consequences.
- Published
- 2021