6-PACK STUDY PROGRESS

Stage 1: pre-implementation

September 2011- December 2011.
Analysis of data from this stage included 12,280 patients, 775 falls and 305 fall related injuries.
Key findings include:

  • Falls remain a prevalent and deleterious problem in Australian hospitals - 1 in 15 acute medical and surgical patients fall during their admission and more than 1 in 4 falls result in injury
  • A review of the sensitivity of data sources for capturing fall and injurious fall events found 61% of falls are recorded on the incident reporting database and 84% in the medical record.

Stage 2: cluster RCT

January 2012 - April 2013.
This phase involved implementation of the 6-PACK program on all intervention wards while control wards continued with usual care. Implementation was supported by the 6-PACK program and change management facilitators and was guided by findings from focus groups, surveys and interviews conducted with nurses and senior management staff as part of Stage 1.
Implementation strategies included:
  • Executive and ward leadership
  • On-ward face-to-face training
  • Access to falls prevention resources
  • Feedback of audit and outcome data to ward nurses
Data collection for the cluster RCT period completed in April 2013. Recruitment exceeded expectations with the primary and secondary analyses of data from Stage 2 including 31,398 patients, 43,837 patient ward admissions, 1,839 falls and 613 fall injuries. Finalisation of the outcome paper to a peer reviewed journal is currently underway. Implementation resource and hospital costing data is currently being finalised to allow for commencement of an economic evaluation.
On completion of Stage 2, all participating sites commenced the sustainability phase.

Stage 3: sustainability

April 2013 - December 2013.
During this period, implementation support from researchers was withdrawn, whilst data collection of fall and fall injuries continued to be collected from the hospital incident reporting database and hospital administrative extracts.