Implementation experience of a guideline on fall prevention in Centres Committed to Excellence in Care®. / Experiencia en la implantación de la Guía de prevención de caídas en Centros Comprometidos con la Excelencia en Cuidados®.

AIM: To describe the progress of implementing the «Preventing falls¼ Guideline of the Best Practice Spotlight Organization (BPSO®) Programme and fall outcomes in Centres Committed to Excellence in Care (CCEC®). METHOD: A Quasi-experimental study pre-post test from a multicentric approach carried out between 2012-2018. The study is focused on patients aged 65 or older, discharged from guideline implementation units, analysing sociodemographic variables (sex, age, hospitalization days; fall risk assessment on admission and patient in risk; fall prevention plan; incidence of falls. Data was compared from CCEC® programme indicators measured over the periods: baseline (T1), candidate during the first three years (T2), and sustainability (T3). Descriptive and inferential analysis was performed. RESULTS: 31,486 patients were evaluated in 7 centres (T1=465; T2=14,255; T3=16,766). Of the patients, 51.87% were men and average age was 79.06 years. Hospitalization was 8.15 days. Fall risk assessment on admission was performed in 81.96% of patients (T1=44.30%, T2=81.11%, T3=83.73%) and 52.31% patients had high risk. A prevention falls plan was registered in 47.75% of patients (T1=24.73%, T2=42.43%, T3=52.90%). Four hundred and twenty-three falls were recorded, 62.17% without injuries. CONCLUSIONS: Despite the differences between hospitals, such as structural characteristics, strategies, assessment tools and data progression pace; adherence to recommendations is proving successful, improving widely. Guideline implementation has allowed fall problems to be addressed, producing positive changes in the process and encouraging the implementation and sustainability of evidence-based nursing practice.

Experiencia en la implantación de la Guía de prevención de caídas en Centros Comprometidos con la Excelencia en Cuidados / Implementation experience of a guideline on fall prevention in Centres Committed to Excellence in Care

OBJETIVO: Describir la progresión del grado de adherencia a las recomendaciones de la Guía «Prevención de caídas» del Programa Best Practice Spotlight Organization (BPSO®) y resultados en caídas en los Centros Comprometidos con la Excelencia en Cuidados (CCEC®). MÉTODO: Estudio cuasiexperimental pretest-postest con carácter multicéntrico desarrollado entre 2012 y 2018. Se incluye a los pacientes ≥65 años, dados de alta en las unidades de implantación de la Guía, analizando variables sociodemográficas (sexo, edad); estancia hospitalaria; valoración del riesgo de caídas al ingreso y pacientes con riesgo; plan de cuidados para la prevención de caídas e incidencia de caídas. Se han comparado los indicadores del programa CCEC® medidos en los periodos: basal (T1), de candidatura en los 3 primeros años (T2) y de sostenibilidad (T3). Se ha realizado un análisis estadístico descriptivo e inferencial. RESULTADOS: Se ha evaluado a 31.486 pacientes de 7 centros hospitalarios (T1=465; T2=14.255; T3=16.766). El 51,87% fueron hombres, con una edad media de 79,06 años. La estancia hospitalaria fue 8,15 días. La valoración del riesgo al ingreso se realizó en el 81,96% (T1=44,30%; T2=81,11%; T3=83,73%), estando en riesgo un 52,31%. Tenían planificados cuidados para prevenir caídas un 47,75% (T1=24,73%; T2=42,43%; T3=52,90%). De las 423 caídas registradas, el 62,17% no tuvieron lesiones. CONCLUSIONES: A pesar de las diferencias entre hospitales, como las características estructurales, las estrategias, los instrumentos de valoración y el ritmo en la progresión de datos, el grado de adherencia a las recomendaciones está siendo exitoso mejorando de forma generalizada. La implantación de la Guía ha permitido abordar la problemática de las caídas, produciendo cambios positivos en el proceso y favoreciendo la implantación y sostenibilidad de prácticas basadas en la evidencia

AIM: To describe the progress of implementing the «Preventing falls» Guideline of the Best Practice Spotlight Organization (BPSO®) Programme and fall outcomes in Centres Committed to Excellence in Care (CCEC®). METHOD: A Quasi-experimental study pre-post test from a multicentric approach carried out between 2012-2018. The study is focused on patients aged 65 or older, discharged from guideline implementation units, analysing sociodemographic variables (sex, age, hospitalization days; fall risk assessment on admission and patient in risk; fall prevention plan; incidence of falls. Data was compared from CCEC® programme indicators measured over the periods: baseline (T1), candidate during the first three years (T2), and sustainability (T3). Descriptive and inferential analysis was performed. RESULTS: 31,486 patients were evaluated in 7 centres (T1=465; T2=14,255; T3=16,766). Of the patients, 51.87% were men and average age was 79.06 years. Hospitalization was 8.15 days. Fall risk assessment on admission was performed in 81.96% of patients (T1=44.30%, T2=81.11%, T3=83.73%) and 52.31% patients had high risk. A prevention falls plan was registered in 47.75% of patients (T1=24.73%, T2=42.43%, T3=52.90%). Four hundred and twenty-three falls were recorded, 62.17% without injuries. CONCLUSIONS: Despite the differences between hospitals, such as structural characteristics, strategies, assessment tools and data progression pace; adherence to recommendations is proving successful, improving widely. Guideline implementation has allowed fall problems to be addressed, producing positive changes in the process and encouraging the implementation and sustainability of evidence-based nursing practice