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dc.contributor.authorGrealish, Laurie
dc.contributor.authorReal, Belinda
dc.contributor.authorTodd, Jo-Anne
dc.contributor.authorDarch, Jacob
dc.contributor.authorSoltau, Dawn
dc.contributor.authorPhelan, Maggie
dc.contributor.authorLunn, Matthew
dc.contributor.authorBrandis, Susan
dc.contributor.authorCooke, Marie
dc.contributor.authorChaboyer, Wendy
dc.date.accessioned2019-07-11T05:31:09Z
dc.date.available2019-07-11T05:31:09Z
dc.date.issued2019
dc.identifier.issn1545-102X
dc.identifier.doi10.1111/wvn.12376
dc.identifier.urihttp://hdl.handle.net/10072/386064
dc.description.abstractBackground: Evidence-based guidelines assist clinicians in practice, but how the guidelines are implemented is less established. Aim: To describe the nurses’ implementation of activities recommended in evidence-based guidelines for falls prevention and care of older people with cognitive impairment. Methods: Structured observation with a categorical checklist was used. Nursing personnel were recruited from one subacute and two acute wards in two hospitals in one tertiary-level health service in south-eastern Queensland, Australia. The data collection instrument identified 31 activities drawn directly from the evidence-based guidelines, which were categorized into six domains of nursing practice: clinical care, comfort, elimination, mobility, nutrition and hydration, and social engagement. Four-hour observation periods, timed to occur across the morning and evening shifts, were conducted over 2 months. Results: Nineteen registered nurses, six enrolled nurses, and 16 assistants in nursing (N = 41) were observed for 155 hr of observation. There was variability in adherence with specific activities, ranging from 21% to 100% adherence. Three categories with the highest adherence were nutrition and hydration, mobilization safety, and social engagement. The clinical care, comfort, and elimination categories had lower adherence, with lowest adherence in activities of education provision about falls risk, pain assessment, using a clock or calendar to reorient to time and place, and bowel care. Linking Evidence to Action: Nursing care is delivered within an interdisciplinary team. Therefore, responsibility for the everyday fundamental care activities known to prevent falls in older people with cognitive impairment requires localized negotiation. A practical guide for preventing in-hospital falls in older people with cognitive impairment addressing the interdisciplinary context of practice is required. Interdisciplinary teams should develop strategies to enhance the implementation of pain assessment and prevention of constipation in the context of regularly implemented hydration, nutrition, and mobilization care strategies.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.relation.ispartofpagefrom1
dc.relation.ispartofpageto9
dc.relation.ispartofjournalWorldviews on Evidence-Based Nursing
dc.subject.fieldofresearchNursing
dc.subject.fieldofresearchcode1110
dc.titleImplementing Evidence-Based Guidelines for Falls Prevention: Observations of Nursing Activities During the Care of Older People With Cognitive Impairment
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.rights.copyright© 2019 Sigma Theta Tau International Honor Society of Nursing. This is the author-manuscript version of this paper. Reproduced in accordance with the copyright policy of the publisher. Please refer to the journal's website for access to the definitive, published version.
gro.hasfulltextFull Text
gro.griffith.authorGrealish, Laurie A.
gro.griffith.authorChaboyer, Wendy
gro.griffith.authorCooke, Marie L.
gro.griffith.authorTodd, Jo-anne
gro.griffith.authorLunn, Matthew P.


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