WHAT WORKS, WHAT DOESN’T, AND WHY: LEARNINGS FROM THE WORLD’S LARGEST HOSPITAL FALLS PREVENTION TRIAL

Patient falls remain a common cause of harm in hospitals worldwide. Recent studies suggest harm is increasing despite investment in practice guidelines and implementation of prevention programs. This symposium presents key learnings from the 6-PACK project which will be compared to the learnings of prior studies. 6-PACK is a nurse-led falls prevention program reflective of Australian hospital accreditation standards and best practice guideline recommendations. The 6-PACK project incorporated a study of falls prevention beliefs, practice, safety climate and outcomes; a cluster RCT testing effectiveness of the 6-PACK, including economic and program evaluations; and an assessment of sustainability of practice and outcomes. It collected information from 540 staff and 50,150 patients from 24 wards across six Australian hospitals. This symposium includes four presentations. In the first, the 6-PACK RCT results will be presented including impacts on practice, falls and fall injuries; and implementation fidelity of the 6-PACK during the trial. The second reviews known barriers and enablers to the implementation of falls prevention programs and compares these to those experienced in the 6-PACK. The third presents findings of a cost of falls study conducted alongside the RCT. The final presentation summarizes evidence relating to patient safety climate and falls, including measurement tools and climate in the wards participating in 6-PACK. The symposium will conclude by discussing novel solutions to hospital falls by the discussant, who will review the presented findings in terms of impact and clinical implications; and also compare to UK and European activities including NICE guidelines and FallSafe.