Falls in long-term care institutions for elderly people: protocol validation

Methodological, quanti-qualitative study using the Delphi technique. The tool, based on the literature, was sent electronically to obtain consensus among the 14 experts that meet the defined inclusion criteria.

Results:

The 27 indicators of the protocol are organized in three dimensions: prepare for the institutionalization (IRA=.88); manage the risk of falls throughout the institutionalization (IRA=.9); and lead the communication and formation (IRA=1), with a CVI=.91. Two rounds were performed to get a consensus superior to 80% in every item.

Conclusion:

The values obtained in the reliability test (>0.8) show that the protocol can be used to meet the intended goal. The next step is the clinic validation of the protocol with residents of long-term care institutions for elderly people.

Descriptors:
Accidental Falls; Aged; Accident Prevention; Nursing; Institutionalization

	Dimensions of the fall risk management protocol for LTC institutions^* * Long-term care;	CVII^ Content Validity Index, applied to the items of the protocol;	IRA^* ***** Interrater Agreement, applied to the protocol dimensions;	CVI^** ****** Content Validity Index of the protocol
Preparing the institutionalization				0.91
1	Meets the elderly and their family before the admittance to a LTC unit^* * Long-term care; .	0.86	0.77
2	Applies an assessment scale for fall risk.	0.93
3	Applies a scale to evaluate the elderly's practices and behaviors regarding the fall risk management.	0.86
4	Describes rules of good practice.	0.93
5	Tells the fall prevalence rate in the LTC institution^* * Long-term care; .	0.71
6	Contracts the commitment of the family in the elderly person's safety.	0.86
7	Informs the elderly person of the need to report every fall episode.	0.93
8	Formalizes the care continuity with the family nurse.	0.79
9	Hands written information about the criteria for clothes/shoes to bring to the institution.	1.0
Managing the fall risk throughout the institutionalization
10	Evaluates the individual fall risk with a risk assessment tool.	1.0	0.9
11	Controls the environment and equipment.	1.0
12	Manages the daily activities of the elderly.	0.93
13	Manages the care given by different professionals.	0.93
14	Determines the task delegation mechanisms to other professionals.	0.79
15	Evaluates the practices and behaviors of the professionals regarding fall risk management.	1.0
16	Evaluates the practices and behaviors of the elderly regarding fall risk management.	0.86
17	Selects safe supporting products for the execution of daily activities.	0.86
18	Monitors the fall episodes.	0.93
19	Implements strategies to control fall consequences and prevent the decrease of functionality in the post-fall period.	1.0
Leading communication and formation
20	Decides as a team the preventive measures to be implemented.	1.0	1.0
21	Tells the family the individual fall risk factors of the elderly person.	1.0
22	Tells the family the implemented measures.	0.86
23	Evaluates the impact of the implemented preventive measures.	1.0
24	Communicates and reports the fall episodes.	0.93
25	Runs epidemiological studies.	0.93
26	Registers the fall episodes in a national platform.	0.86
27	Sets up the multidisciplinary team.	1.0

	Dimensions of the fall risk management protocol for LTC institutions^* * Long-term care;	CVII^* * Long-term care;	IRA^ Content Validity Index, applied to the items of the protocol;	CVI^* ***** Interrater Agreement, applied to the protocol dimensions;
Preparing the institutionalization				0.93
1	Meets the elderly person and their family before the admittance to a LTC unit^* * Long-term care; .	0.86	1
2	Applies an assessment scale for fall risk.	0.93
3	Applies a scale to evaluate the elderly person's practices and behaviors regarding the fall risk management.	0.86
4	Describes rules of good practice.	0.93
5	Tells the family the fall prevalence rate in the LTC institution^* * Long-term care; .	0.93
6	Contracts the commitment of the family in the elderly person's safety.	0.86
7	Informs the elderly person of the need to report every fall episode.	0.93
8	Assures the care continuity, asking the primary care nurse for information.	0.93
9	Provides written information about the criteria for clothes/shoes to bring to the institution.	1
Managing the fall risk throughout the institutionalization
10	Evaluates the individual fall risk with a risk assessment tool.	1	1
11	Controls the environment and equipment.	1
12	Manages the daily activities of the elderly.	0.93
13	Manages the care given by different professionals.	0.93
14	Determines the task delegation mechanisms to hands-on professionals.	0.86
15	Evaluates the practices and behaviors of the professionals regarding fall risk management.	1
16	Evaluates the practices and behaviors of the elderly person regarding fall risk management.	0.86
17	Selects safe supporting products for the execution of daily activities.	0.86
18	Monitors the fall episodes.	0.93
19	Implements strategies to control fall consequences and prevent the decrease of functionality in the post-fall period.	1
Leading communication and formation
20	Decides as a team the preventive measures to be implemented.	1	1
21	Tells the family the individual fall risk factors of the elderly.	1
22	Tells the family the implemented measures.	0.86
23	Evaluates the impact of the implemented preventive measures.	1
24	Communicates and reports the fall episodes.	0.93
25	Runs epidemiological studies.	0.93
26	Registers the fall episodes in a national platform.	0.86
27	Sets up the multidisciplinary team.	1

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] CORRESPONDING AUTHOR: Cristina Lavareda Baixinho. Email: crbaixinho@esel.pt