Preventing falls in hospitalized elderly: design and validation of an intervention for the team
Injuries resulting from falls are the main causes for hospitalization of the elderly and have a significant impact on the pain and suffering of the person, as well as the loss of their independence, constituting an important source of morbidity and mortality (Burland et al., 2013), the interventions for prevention must be individualized, multidimensional, involving caregivers, the environment and the elderly. What implies that, beyond biomedical understanding, there is a more comprehensive understanding of the fall, that studies the psychological impact, emotions and actions associated with the fall and its necessary prevention (Baixinho & Dixe, 2016).
This study aims to design and validate, by a panel of experts, an intervention for the team to manage the risk of falls in hospitalized elderly.
To answer the objective and the research question of the study: “What interventions in the multidisciplinary team can prevent the occurrence of falls in the hospitalized elderly?” we chose the Delphi method that allows consensus among a panel of experts. This methodological study of quanti-qualitative approach took place in the second semester of 2017. For the validation of the intervention designed, we chose 13 professionals with more than five years of professional activity, working in hospitals and with responsibilities in work groups on falls and elements of safety and quality departments.
The validation of an intervention for multiprofessional teams emerges to support the clinic and research in this area. Despite the criticisms that some authors present regarding the method used and the level of evidence of consensus by experts, we are pleased to advocate that the use of validated instruments is the pillar in the prevention of falls (Ruan et al., 2015), not only for risk assessment but also for intervention.
The analysis of content to the participants' answers in the first phase of the study allowed the definition of the indicators to be placed in each previously defined category: team formation; Communication; leadership; monitoring and mutual support. Based on the analysis of the contributions of five researchers, whose responses were subject to content analysis, the intervention was designed and validated by 13 experts. The values obtained in the reliability test (> 0.8) attest that the intervention can be used in the clinic and research to achieve the desired end. The next step is to implement this intervention in the multidisciplinary teams to evaluate its effectiveness in reducing the prevalence of falls in the hospitalized elderly population.
This study presents the limitations inherent in the method and the sample type, with intentional choice of the participants on the two phases of the investigation. It is also emphasized that the intervention built is based on the self-perception and the clinical.