Abstract:
BACKGROUND:When tested in a randomized controlled trial (RCT) of 31,411 patients, the nurse-led 6-PACK falls prevention program did not reduce falls. Poor implementation fidelity (i.e., program not implemented as intended) may explain this result. Despite repeated calls for the examination of implementation fidelity as an essential component of evaluating interventions designed to improve the delivery of care, it has been neglected in prior falls prevention studies. This study examined implementation fidelity of the 6-PACK program during a large multi-site RCT. METHODS:Based on the 6-PACK implementation framework and intervention description, implementation fidelity was examined by quantifying adherence to program components and organizational support. Adherence indicators were: 1) falls-risk tool completion; and for patients classified as high-risk, provision of 2) a 'Falls alert' sign; and 3) at least one additional 6-PACK intervention. Organizational support indicators were: 1) provision of resources (executive sponsorship, site clinical leaders and equipment); 2) implementation activities (modification of patient care plans; training; implementation tailoring; audits, reminders and feedback; and provision of data); and 3) program acceptability. Data were collected from daily bedside observation, medical records, resource utilization diaries and nurse surveys. RESULTS:All seven intervention components were delivered on the 12 intervention wards. Program adherence data were collected from 103,398 observations and medical record audits. The falls-risk tool was completed each day for 75% of patients. Of the 38% of patients classified as high-risk, 79% had a 'Falls alert' sign and 63% were provided with at least one additional 6-PACK intervention, as recommended. All hospitals provided the recommended resources and undertook the nine outlined program implementation activities. Most of the nurses surveyed considered program components important for falls prevention. CONCLUSIONS:While implementation fidelity was variable across wards, overall it was found to be acceptable during the RCT. Implementation failure is unlikely to be a key factor for the observed lack of program effectiveness in the 6-PACK trial. TRIAL REGISTRATION:The 6-PACK cluster RCT is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12611000332921 (29 March 2011).
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Morello RT,Barker AL,Ayton DR,Landgren F,Kamar J,Hill KD,Brand CA,Sherrington C,Wolfe R,Rifat S,Stoelwinder Jdoi
10.1186/s12913-017-2315-zsubject
Has Abstractpub_date
2017-06-02 00:00:00pages
383issue
1issn
1472-6963pii
10.1186/s12913-017-2315-zjournal_volume
17pub_type
杂志文章abstract:BACKGROUND:The aim of the study is to translate and cross-culturally adapt, for use in the Italian context, the Communication Assessment Tool (CAT) developed by Makoul and colleagues. METHODS:The study was performed in the out-patient clinic of the Surgical Department of Cardarelli Hospital in Naples, Italy. It involv...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1411-9
更新日期:2016-04-29 00:00:00
abstract:BACKGROUND:Health practitioners frequently encounter dying, death and suffering. While providing health care can be stressful, the literature on how different health practitioners cope with the emotional challenges associated with their work is sparse. Further, much of this literature is based on studies conducted in h...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2646-9
更新日期:2017-12-04 00:00:00
abstract:BACKGROUND:Assessing client and patient satisfaction towards a service is of programmatic importance. A study was conducted in Malawi between July and October 2013 to assess client satisfaction among women who had been screened for cervical cancer using Visual Inspection with Acetic acid test. METHODS:This was a cross...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-420
更新日期:2014-09-22 00:00:00
abstract:BACKGROUND:Adherence to medication is one of the critical determinants of successful management of chronic diseases including asthma and chronic obstructive pulmonary disease (COPD). Given that poor adherence with self-management medication is very common among asthma and COPD patients, interventions that improve the u...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-0998-6
更新日期:2015-08-17 00:00:00
abstract:BACKGROUND:Concerns have been raised regarding the reasonableness of using personal health responsibility as a principle or criterion for setting priorities in healthcare. While this debate continues, little is known about clinicians' views on the role of patient responsibility in clinical contexts. This paper contribu...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05364-6
更新日期:2020-06-03 00:00:00
abstract:BACKGROUND:Previous self-harm is one of the strongest predictors of future self-harm and suicide. Increased risk of repeated self-harm and suicide exists amongst patients presenting to hospital with high-risk self-harm and major self-harm repeaters. However, so far evidence-based training in the management of self-harm...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05254-x
更新日期:2020-06-22 00:00:00
abstract:BACKGROUND:For the treatment of depression in diabetes patients, it is important that depression is recognized at an early stage. A screening method for depression is the patient health questionnaire (PHQ-9). The aim of this study is to validate the 9-item Patient Health Questionnaire (PHQ-9) as a screening instrument ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-10-235
更新日期:2010-08-12 00:00:00
abstract:BACKGROUND:Analysis of patient mobility in a country not only gives an idea of how the health-care system works, but also can be a guideline to determine the quality of health care and health disparity among regions. Even though determination of patient movement is important, it is not often realized that patient mobil...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2381-2
更新日期:2017-07-04 00:00:00
abstract::An amendment to this paper has been published and can be accessed via the original article. ...
journal_title:BMC health services research
pub_type: 杂志文章,已发布勘误
doi:10.1186/s12913-020-05545-3
更新日期:2020-07-22 00:00:00
abstract:BACKGROUND:Acute low back pain is one of the most common reasons for individuals to seek medical care in the United States. The US Military Health System provides medical care to approximately 9.4 million beneficiaries annually. These patients also routinely suffer from acute low back pain. Within this health system, p...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3525-8
更新日期:2018-09-17 00:00:00
abstract:BACKGROUND:Smoking during pregnancy is a major public health concern and an NHS priority. In 2010, 26% of UK women smoked immediately before or during their pregnancy and 12% smoked continuously. Smoking cessation support is provided through free at the point of use Stop Smoking Services for Pregnant women (SSSP). Howe...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-107
更新日期:2014-03-04 00:00:00
abstract:BACKGROUND:In Brazil, health is fundamental human right guaranteed by the Constitution of 1988, which created the Brazilian Universal Health System (Sistema Único de Saúde - SUS). The SUS provides medications for outpatient care via policy of pharmaceutical assistance (PA) programmes. Despite the advances in PA policie...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2430-x
更新日期:2017-07-19 00:00:00
abstract:BACKGROUND:This study investigated prognosis among patients under prolonged mechanical ventilation (PMV) through exploring the following issues: (1) post-PMV survival rates, (2) factors associated with survival after PMV, and (3) the number of days alive free of hospital stays requiring mechanical ventilation (MV) care...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-100
更新日期:2012-04-25 00:00:00
abstract:BACKGROUND:Hospitals in European countries apply a wide range of quality improvement strategies. Knowledge of the effectiveness of these strategies, implemented as part of an overall hospital quality improvement system, is limited. METHODS/DESIGN:We propose to study the relationships among organisational quality impro...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-10-281
更新日期:2010-09-24 00:00:00
abstract:BACKGROUND:Pay-for-Performance programs have shown improvement in indicators monitoring adequacy and target achievement in diabetic care. However, less is known regarding the impact of this program on the occurrence and long-term effects of diabetic retinopathy. The objective of this study was to determine the effect o...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3454-6
更新日期:2018-08-15 00:00:00
abstract:BACKGROUND:The appropriate use of the Partograph allows early identification of labour related complications and prevents deaths. We, therefore, sought to determine the level of Partograph completion and healthcare worker perspectives towards its utilization. METHODS:This study had two components; a hospital-based cro...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-3934-3
更新日期:2019-02-07 00:00:00
abstract:BACKGROUND:Patient-centered care ideally considers patient preferences, values and needs. However, it is unclear if policies such as wait time strategies for hip and knee replacement surgery (TJR) are patient-centred as they focus on an isolated episode of care. This paper describes the accounts of people scheduled to ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-13-531
更新日期:2013-12-23 00:00:00
abstract:BACKGROUND:Home care (HC) is a critical component of the ongoing restructuring of healthcare in Canada. It impacts three dimensions of healthcare delivery: primary healthcare, chronic disease management, and aging at home strategies. The purpose of our study is to investigate a significant safety dimension of HC, the o...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-13-227
更新日期:2013-06-22 00:00:00
abstract::Following publication of the original article [1], the author reported that their first names and last names were swapped. The original article has been corrected. ...
journal_title:BMC health services research
pub_type: 杂志文章,已发布勘误
doi:10.1186/s12913-018-3597-5
更新日期:2018-10-11 00:00:00
abstract:BACKGROUND:Healthcare obtained abroad may conflict with care received in the country of residence. A special concern for immigrants has been raised as they may have stronger links to healthcare services abroad. Our objective was to investigate use of healthcare in a foreign country in Turkish immigrants, their descenda...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-390
更新日期:2012-11-13 00:00:00
abstract:BACKGROUND:In average-risk individuals aged 50 to 75 years, there is no difference in life-years gained when comparing colonoscopy every 10 years vs. annual fecal immunochemical testing (FIT) for colorectal cancer screening. Little is known about the preferences of patients when they have experienced both tests. METHO...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-0841-0
更新日期:2015-04-23 00:00:00
abstract:BACKGROUND:Safety management systems have been set up in healthcare institutions to reduce the number of adverse events. Safety management systems use a combination of activities, such as identifying and assessing safety risks in the organizational processes through retrospective and prospective risk assessments. A com...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-103
更新日期:2014-03-03 00:00:00
abstract:BACKGROUND:Among all women who experienced an abortion in Sweden 2017, 45% had previously underwent at least one abortion. This phenomenon of increasing rates of repeat abortions stimulated efforts to improve contraceptive services through a Quality Improvement Collaborative (QIC) with user involvement. The participati...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05799-x
更新日期:2020-10-16 00:00:00
abstract:BACKGROUND:General practitioners (GPs) adopt clinical practice guidelines to varying degrees. Several factors have been found to influence application of guidelines in practice and the GP is apparently the key actor. Studies are needed to increase our understanding of how GPs' attitudes influence their use of guideline...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-8-218
更新日期:2008-10-22 00:00:00
abstract:BACKGROUND:Australia has a universal health care system and a comprehensive safety net. Despite this, outcomes for Australians living in rural and remote areas are worse than those living in cities. This study will examine the current state of equity of access to birthing services for women living in small communities ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2084-8
更新日期:2017-02-23 00:00:00
abstract:BACKGROUND:The Whole Systems Demonstrator was a large, pragmatic, cluster randomised trial that compared telehealth with usual care among 3,230 patients with long-term conditions in three areas of England. Telehealth involved the regular transmission of physiological information such as blood glucose to health professi...
journal_title:BMC health services research
pub_type: 杂志文章,随机对照试验
doi:10.1186/1472-6963-14-334
更新日期:2014-08-06 00:00:00
abstract:BACKGROUND:Ageing of Mexican population implies greater demand of hospital services. Nevertheless, the available resources are used inadequately. In this study, the direct medical costs associated with the appropriateness of elderly populations hospital stay are estimated. METHODS:Appropriateness of hospital stay was ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-9-151
更新日期:2009-08-22 00:00:00
abstract:BACKGROUND:Travel burden is a key element in conceptualizing geographic access to health care. Prior research has shown that both rural and minority populations bear disproportionate travel burdens. However, many studies are limited to specific types of patient or specific locales. The purpose of our study was to quant...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-7-40
更新日期:2007-03-09 00:00:00
abstract:BACKGROUND:The aim of this study was to compare the expressed levels of career satisfaction of three groups of comparable dental healthcare professionals, working in Trinidad, the United Kingdom and New Zealand. METHODS:Three questionnaire surveys were carried out of comparable dental healthcare professionals. Dental ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-6-32
更新日期:2006-03-14 00:00:00
abstract:BACKGROUND:Comprehensive policies are becoming common for addressing wicked problems in health and social care. Success of these policies often varies between target organizations. This variation can often be attributed to contextual factors. However, there is a lack of knowledge about the conditions for successful pol...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4591-2
更新日期:2019-10-22 00:00:00