Life In The Slower Lane

Here is the standardised PICO analysis for the forty-second uploaded article:

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Full Title

Adopting the Fall Tailoring Interventions for Patient Safety (TIPS) Program to Engage Older Adults in Fall Prevention in a Nursing Home

Authors: Huey-Ming Tzeng, Lynn S. Jansen, Udoka Okpalauwaekwe, Srijesa Khasnabish, Brenda Andreas, Patricia C. Dykes

Journal: Journal of Nursing Care Quality, 2021; 36(4): 327–332

DOI: 10.1097/NCQ.0000000000000547

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Type of Study

Quality Improvement (QI) pilot project using a pre-post intervention design

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PICO Summary

Population (P)

• Older adult residents in a 15-bed subacute care unit within a 225-bed government-funded nursing home in Saskatchewan, Canada
• Residents typically involved in rehabilitation, hospice, palliative, and respite care
• All residents were over 65 years of age, and many had significant mobility or cognitive impairments

Intervention (I)

• Implementation of the Fall TIPS (Tailoring Interventions for Patient Safety) program, adapted from hospital to nursing home setting
• Fall TIPS includes:
  1. Fall risk assessment (using the Morse Fall Scale)
  2. Development of a personalised fall prevention plan
  3. Active engagement of residents in implementing the plan
• Delivered via laminated bedside posters (with icons) co-created by residents and staff
• Supported by peer champions, staff training, and feedback loops

Comparison (C)

• Pre-intervention fall rates served as baseline for comparison
• Timeframe:
  • Pre-intervention: April–December 2018
  • Post-intervention: April–December 2019

Outcomes (O)

Primary outcomes (per 1000 resident-days):

• Average monthly fall rate:
  • Before: 10.07 (range: 0–17.18)
  • After: 7.95 (range: 0–19.35)
• Average monthly injurious fall rate:
  • Before: 2.91
  • After: 1.01
• All reported injuries were minor (Level 2); no adverse or catastrophic events were reported 

Qualitative feedback:

• Residents appreciated the visual, icon-based approach
• Staff found the tool easy to integrate into workflow
• Engagement led to increased resident compliance and awareness of fall prevention strategies

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Findings Summary

This QI initiative suggests that the Fall TIPS program, when adapted for use in a residential aged care setting, can:

• Reduce both overall and injurious falls
• Engage residents more actively in their care
• Be integrated with minimal disruption to existing workflows using accessible bedside tools

Limitations:

• Small sample size (single unit)
• No individual resident-level demographic or risk data
• No statistical analysis due to limited data points

The findings support a person-centred, participatory approach to fall prevention in long-term care, with potential for broader implementation and more robust evaluation in future research.

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