title: Investigating the impact of a falls prevention community of practice in a residential aged-care setting: a mixed methods study protocol.
abstract: OBJECTIVE
  The aim of this study was to facilitate the implementation and operation of a falls prevention Community of Practice in a residential aged-care organization and evaluate its effect on falls outcomes.
  
  
  BACKGROUND
  Falls are a substantial concern across the residential aged-care sector with half its older population falling annually. Preventing falls requires tailoring of current evidence for reducing falls and adoption into daily activity, which is challenging for diversely skilled staff caring for a frailer population. Forming a community of practice could provide staff with the opportunity to share and develop their expertise in falls prevention and innovate change.
  
  
  METHODS
  A mixed methods design based on a realist approach conducted across 13 residential care facilities (N = 779 beds).
  
  
  METHODS
  Staff will be invited to become a member of the community of practice with all sites represented. The community of practice will be supported to audit falls prevention activity and identify gaps in practice for intervention. The impact of the community of practice will be evaluated at three levels: individual member level, facility level and organizational level. A pre-post design using a range of standardized measures supported by audits, surveys, focus groups and interviews will determine its effect on falls prevention practice. Falls outcomes will be compared at five time intervals using negative binomial regression and logistic regression. The study is funded 2013-2017.
  
  
  CONCLUSIONS
  Findings from this research will assist residential aged-care providers to understand how to effectively translate evidence about falls prevention into clinical practice.
authors.affiliation: School of Physiotherapy, Institute of Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Francis-Coad
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Etherton-Beer
authors.affiliation: School of Nursing and Midwifery, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
authors.forename: Caroline
authors.initials: C
authors.lastname: Bulsara
authors.affiliation: Brightwater Care Group, Osborne Park, Western Australia, Australia.
authors.forename: Debbie
authors.initials: D
authors.lastname: Nobre
authors.affiliation: School of Physiotherapy, Institute of Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Hill
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D055318:Evidence-Based Nursing / Q000592:standards*; D005260:Female; D006707:Homes for the Aged / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000592:standards*; D017410:Practice Guidelines as Topic; D017751:Safety Management / Q000379:methods*; D014904:Western Australia
keywords: allied health professionals; community of practice; falls prevention; nurses; residential aged-care; staff education