Reference standard for the prevention and management of hospital falls: a multidisciplinary Delphi consensus study
Year: 2025
Type: article
Abstract: BACKGROUND: Hospital falls persist as a major threat to patient safety. This study aimed to develop an interprofessional reference standard to prevent, manage and report hospital falls. METHODS: A Delphi consensus methodology, informed by the Conducting and Reporting Delphi Studies guideline, was used to design the reference standard. An interprofessional expert panel (n=47) of health professionals, researchers, policymakers and consumers participated in three Delphi rounds. Following the review of clinical guidelines, an e-Delphi survey was developed and piloted to derive 60 initial items for the standard. Two iterative rounds of e-Delphi surveys were distributed via Research Electronic Data Capture and included free-text questions and 9-point Likert scales. An online consensus meeting followed, to ratify the final standard. RESULTS: In the first Delphi round, there was over 80% agreement for 44/60 items to be included in the reference standard. This increased to 48/60 items in Round 2. At the final consensus meeting, 12 items still did not reach consensus for inclusion and one was added, yielding 49 items. Items that replicated text according to falls with injury/without injury were combined, resulting in 42 items in the final reference standard. Agreed items included: (1) brief screening of falls risk on hospital admission; (2) comprehensive falls assessment for inpatients who are older, frailer or have complex conditions; (3) single interventions (such as environmental adaptations and exercise); (4) multifactorial interventions; (5) education of patients, families and staff; (6) optimising local falls hospital policies, procedures and leadership capability; (7) optimising documentation and reporting; (8) improving accreditation processes; (9) workforce redesign to augment falls education. Items that did not reach agreement (n=12) pertained to alarms, bed rails, grip socks, artificial intelligence, volunteers and care bundles. CONCLUSION: This new reference standard provides a checklist for staff, patients, managers and policymakers to reduce unwanted variations in prevention, management and reporting of hospital falls. TRIAL REGISTRATION NUMBER: ANZCTR 386960.
Source: BMJ Open
Authors: Meg E Morris, Catherine M Said, Terry Haines, Hazel Wei Fen Heng, Frances Batchelor, Alison M Hutchinson, Jonathan P McKercher, Adam Ivan Semciw, Anne-Marie Hill, Stephen Peterson, Richard Kane, Sally Fowler-Davis, Sarah Campbell, Catherine Sherrington, Julia Gilmartin-Thomas, Uyen Phan, Claire Thwaites
Institutions: La Trobe University, The University of Melbourne, Western Health, Monash University, Northern Health, Northern Hospital, National Ageing Research Institute, Deakin University, The University of Western Australia, St Vincent's Hospital Melbourne, Anglia Ruskin University, The University of Sydney, Institute for Musculoskeletal Health, The Alfred Hospital, Alfred Health
Language: English
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,839
OpenAlex ID: W4414883181