Exploring the organisation and delivery of falls management in care homes for older people in England.

IF 3.8 2区 医学 Q2 GERIATRICS & GERONTOLOGY
K Robinson, P L Logan, A L Gordon, S Timmons, T Masud, L Rees, A Kilby, W Lawry, F Hallam-Bowles
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引用次数: 0

Abstract

Background: To explore the organisational context of English care homes in delivering falls management and identify barriers and facilitators to help design future service delivery.

Methods: Non-participant observations and semi-structured interviews in one region of England with care home staff, commissioners and individuals involved in the organisation of falls management, care home managers, care home owners and residents. Barriers and facilitators were identified by thematic analysis and mapped against the Consolidated Framework for Implementation Research (CFIR).

Results: 17 interviews were undertaken including staff and a resident from three care homes. Delivering falls management in care homes was complex and challenged by difficulties in integration across a disjointed system, workforce challenges and managing complexity of resident needs with multiple competing priorities. Facilitators included consistent and regular multi-disciplinary support, valuing team working within the care home, and between the care home and external agencies, and the ability to retain care home staff who developed and honed skills over time and who valued their advocacy role for residents. Variation in care home environments, and access to healthcare support were highlighted.

Conclusions: The delivery of falls management in care homes is complex and involves a number of interacting systems. Implementation strategies to support future delivery need to consider the pressure on care homes and wider systems, workforce challenges and variation between settings.

Abstract Image

探索组织和交付跌倒管理的养老院为老年人在英国。
背景:探索英国护理院在提供跌倒管理方面的组织环境,并确定障碍和促进因素,以帮助设计未来的服务交付。方法:非参与式观察和半结构化访谈在英格兰的一个地区与养老院工作人员,专员和个人参与跌倒管理组织,养老院管理者,养老院业主和居民。通过专题分析确定了障碍和促进因素,并根据实施研究综合框架(CFIR)绘制了地图。结果:进行了17次访谈,包括来自三家养老院的工作人员和一名居民。在养老院提供跌倒管理是复杂的,并受到跨脱节系统整合困难的挑战,劳动力挑战和管理具有多个竞争优先级的居民需求的复杂性。促进因素包括持续和定期的多学科支持,重视护理院内部以及护理院与外部机构之间的团队合作,以及保留护理院员工的能力,这些员工随着时间的推移发展和磨练了技能,并重视他们对居民的倡导作用。他们强调了护理院环境的差异以及获得医疗保健支持的机会。结论:养老院跌倒管理的交付是复杂的,涉及许多相互作用的系统。支持未来交付的实施战略需要考虑到护理院和更广泛系统的压力、劳动力挑战和环境之间的差异。
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来源期刊
BMC Geriatrics
BMC Geriatrics GERIATRICS & GERONTOLOGY-
CiteScore
5.70
自引率
7.30%
发文量
873
审稿时长
20 weeks
期刊介绍: BMC Geriatrics is an open access journal publishing original peer-reviewed research articles in all aspects of the health and healthcare of older people, including the effects of healthcare systems and policies. The journal also welcomes research focused on the aging process, including cellular, genetic, and physiological processes and cognitive modifications.
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