title: Feasibility of implementing a practice guideline for fall prevention on geriatric wards: a multicentre study.
abstract: BACKGROUND
  About 40% of all adverse events in hospital are falls, but only about one in three Belgian hospitals have a fall prevention policy in place. The implementation of a national practice guideline is urgently needed.
  
  
  OBJECTIVE
  This multicentre study aimed to determine the feasibility of a previously developed guideline. SETTING, PARTICIPANTS AND METHOD: Seventeen geriatric wards, selected at random out of 40 Belgian hospitals who agreed to take part in the study, evaluated the fall prevention guideline. After the one-month test period, 49 healthcare workers completed a questionnaire on the feasibility of the guideline.
  
  
  RESULTS
  At the end of the study, 512 geriatric patients had been assessed using the practice guideline. The average time spent per patient on case finding, multifactorial assessment and initiating a treatment plan was 5.1, 76.1 and 30.6 min, respectively. For most risk assessments and risk modifications, several disciplines considered themselves as being responsible and capable. The majority (more than 69%) of the respondents judged the practice guideline as useful, but only a small majority (62.3%) believed that the guideline could be successfully integrated into their daily practice over a longer period of time. Barriers for implementation included a large time investment (81.1%), lack of communication between the different disciplines (35.8%), lack of motivation of the patient (34.0%), lack of multidisciplinary teamwork (28.3%), and lack of interest from the hospital management (15.4%).
  
  
  CONCLUSIONS
  Overall, the guideline was found useful, and for each risk factor (except for visual impairment), at least one discipline felt responsible and capable. Towards future implementation of the guideline, following steps should be considered: division of the risk-factor assessment duties and interventions among different healthcare workers; patient education; appointment of a fall prevention coordinator; development of a fall prevention policy with support from the management of the hospital.
authors.affiliation: Center for Health Services and Nursing Research, KU Leuven, Kapucijnenvoer 35, 4th Floor, 3000 Leuven, Belgium. koen.milisen@med.kuleuven.be
authors.forename: Koen
authors.initials: K
authors.lastname: Milisen
authors.forename: Joke
authors.initials: J
authors.lastname: Coussement
authors.forename: Hanne
authors.initials: H
authors.lastname: Arnout
authors.forename: Virginie
authors.initials: V
authors.lastname: Vanlerberghe
authors.forename: Leen
authors.initials: L
authors.lastname: De Paepe
authors.forename: Didier
authors.initials: D
authors.lastname: Schoevaerdts
authors.forename: Margareta
authors.initials: M
authors.lastname: Lambert
authors.forename: Nele
authors.initials: N
authors.lastname: Van Den Noortgate
authors.forename: Kim
authors.initials: K
authors.lastname: Delbaere
authors.forename: Steven
authors.initials: S
authors.lastname: Boonen
authors.forename: Eddy
authors.initials: E
authors.lastname: Dejaeger
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D005240:Feasibility Studies; D005853:Geriatrics; D006757:Hospital Units; D006801:Humans; D017410:Practice Guidelines as Topic