You are here

Article Text

Article menu

Download PDFPDF

XML
BMJ Quality Improvement report
Focused educational intervention improves but may not sustain knowledge regarding falls management
  1. Punith Kempegowda1,
  2. Joht Singh Chandan2,
  3. Richard Hutton3,
  4. Lauren Brown3,
  5. Wendy Madden4,
  6. June Webb4,
  7. Alison Doyle4,
  8. Jonathan Treml4
  1. 1 Specialist registrar in Endocrinology, Diabetes and General Internal Medicine, Health Education West Midlands, UK
  2. 2 Department of Cardiology, Birmingham City Hospital, Birmingham, UK
  3. 3 Medical School, University of Birmingham, Birmingham, UK
  4. 4 Department of Geriatric Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
  1. Correspondence to Dr Joht Singh Chandan; joht.chandan{at}nhs.net

Abstract

Background The number of falls in hospital ranges from 3.8 to 8.6 falls per 1000 bed days.1 Around 30% of falls as inpatients are injurious, and 4%–6% can result in serious and life-threatening injury.2 3 This results in significant health burdens and economic burdens due to increased hospital stays following a fall. Junior doctors are usually the first point of contact for managing patients who fall in hospital. It is therefore important they understand the preventative measures and postfalls management.

Aim To assess the retention of knowledge regarding falls management in foundation year 1 (FY1) doctors before and after a short educational intervention.

Methods A 3-stage quality improvement project was conducted at a West Midlands teaching hospital to highlight issues regarding falls management. A questionnaire assessing areas of knowledge regarding assessment and management of falls was delivered to 31 F1s. This was followed by a short presentation regarding falls management. The change in knowledge was assessed at 6 and 16 weeks postintervention. The questionnaire results were analysed using unpaired t-tests on STATA (V.14.2).

Results The mean score for knowledge regarding falls management in the preintervention, early postintervention and late postintervention were 73.7%, 85.2% and 76.4%, respectively. Although there was an improvement in the knowledge at 6 weeks’ postintervention, this returned to almost baseline at 16 weeks. The improvement in knowledge did not translate to clinical practice of falls management during this period.

Conclusion Although educational interventions improve knowledge, the intervention failed to sustain over period of time or translate in clinical practice. Further work is needed to identify alternative methods to improve sustainability of the knowledge of falls and bring in the change in clinical practice.

  • quality improvement
  • medical education
  • team training

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjoq-2017-000222

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors All authors were involved in the design of the study. PK, JSC, RH, LB, JW, WM and AD were responsible in the collection of the data. PK and JSC were responsible for the data analysis. PK, JSC, RH, LB and JT were mainly responsible for the drafts of the write-up which were agreed on by all authors.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval This work was intended to improve patient safety and care without carrying out interventions on human subjects. As such, under Trust policy at the Queen Elizabeth Hospital, Birmingham it was exempt from ethical approval being an improvement study rather than a study on human subjects. However, the study was registered on the internal audit mechanism. All patient data was anonymised during analysis.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The raw anonymised data from the study is held by the authors who can be contacted if it is wished to be reproduced elsewhere.