Factors Influencing the Implementation of Evidence-Based Falls Prevention Interventions for Older Persons Living in Residential long-term care settings - An Umbrella Review of Systematic Reviews.

Abstract

Falls among older adults in residential long-term care (RLTC) remain a significant concern, with prevention efforts often yielding inconsistent results due to the complexity of implementation. This umbrella review synthesised evidence from ten systematic reviews to explore the factors influencing the implementation of falls prevention interventions in RLTC, using the i-PARIHS framework. Six EBSCO databases and Scopus were searched without date or language limiters. Risk of bias was assessed using the AMSTAR-2 checklist. The review was conducted in accordance with the PRIOR guideline for overviews of reviews. Seventy-three specific factors were identified. Interventions that are simple, engaging, tailored, and supported by leadership were more effectively adopted. Staff knowledge, clarity of roles, and multidisciplinary collaboration and co-design further facilitated implementation, while organisational constraints such as limited resources, rigid routines, and under-resourcing posed substantial barriers. External contextual influences, including funding mandates and policy frameworks. Moreover, this review identified four factors that did not fall under any of the key characteristics of the i-PARIHS framework: the technological fit of innovations, the health status of residents, changes within the RLTC population, and facilitators' skills in navigating complexity. This review underscores the importance of contextually sensitive, system-wide strategies that consider the evolving realities of RLTC.