Effectiveness of Clinical Practice Guidelines Implementation for Repeated Fall Prevention among Elderly people with Hip Fracture, Lamphun Hospital

Abstract

Background:    Hip fracture is the frequent incident among elderly people and it tends to increase more.

Objective:        To develop clinical practice guidelines and effectiveness of clinical practice guidelines implementation in preventing repeated fall among elderly people who had hip fracture in Lamphun Hospital.

Study design: The samples of this study consisted of 24 professional nurses working in Orthopedic patient nursing group, Lamphun hospital and 30 elderly patients in Orthopedic men surgical ward and Orthopedic women and girls surgical ward, Lamphun hospital from August to September 2019. The research instrument was nursing practice guidelines.  The assessment tool was composed of a demographic data record and a fall data record form, and fall incident record form, patient’s satisfactory assessment form and caregiver’s satisfactory assessment form. Qualitative data analysis was based on content analysis while quantitative data analysis was performed by Frequency, Percentage, Mean, Standard Deviation and Fisher’s Exact Probability Test.

Results:            Clinical practice guideline development was an activity developed by National Health and Medical Research Council; NHMRC, 2000, Australia, as well as the review of evidence-based practice comprising six steps; namely, 1) advocacy patient rights and ethics, 2) fall ris assessment, 3) fall prevention activities, 4) health education in fall prevention, 5) continuing care, record in communication with caregivers team and 6) quality service development. In terms of clinical practice guidelines effectiveness, it revealed that after implementing clinical practice guidelines for repeated fall prevention among elderly people who had hip fracture in Lamphun Hospital, it decreased at p>0.05 level of statistical significance. The patients sample and caregivers team were satisfied with nursing practice by using clinical practice guidelines in the highest level (4.37 and 4.26 in average, respectively).

Conclusions:    Clinical practice guidelines development for repeated falls prevention among elderly people who had hip fracture was considered to be the quality service development process focusing on effectiveness in decreasing repeated fall incident in elderly people who had hip fracture and enhancing knowledge and understanding for caregivers team in nursing elderly people who had hip fracture from evidence-based practice.

Keywords:        clinical practice guidelines, repeated falls, hip fracture