Chronoprevention in Hospital Falls of Older People (CHRONOFALLS)

Chronoprevention in Hospital Falls of Older People: A Nursing Intervention CHRONOFALLS

Accidental falls in hospitals are serious events concerning the safety of the patients. Recent studies demonstrated that the time of falls is a key factor to be considered in prevention. It has been shown that the time of day, the day of the week and the month of the year impact on the occurrence of falls.

The aim of this project is to know the effect of the application of a program of preventive measures based on the temporal patterns of the risk factors on the hospital fall occurrence. A mixed method research design will be conducted. Three phases will be carry out: 1) Longitudinal prospective study in two parts: a) audits and seminars of health professionals focused on an effective and efficient hospital falls register. Cosinor and Multi-Component analyses will be performed to obtain temporal patterns of the hospital falls and their related variables. b) Implementation of a based-temporal patterns, multidimensional prevention program. 2) Retrospective study of falls registered in institutional databases. 3) Qualitative study based on focus groups (physicians, nurses and nursing assistants).

It is imperative to study temporal patterns of hospital falls to effectively and comprehensively define the etiology of falls, and therefore, design preventive strategies. A reduction of the number of in-hospital falls and related injuries is expected, as well as, an improvement of the quality of life of patients. Considering temporal patterns, and levels of mood and sleep of healthcare professionals will achieve an improvement of patient safety.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

-Design

A mixed-method research will be carried out. Three different study design will be used:

Phase 1. Prospective longitudinal study in 2 steps:

  • A first step, of 18 months, in which a first intervention of audits and seminars in health professionals will be carried out, focused on an effective and efficient registry of hospital falls in older people. This first phase is crucial to identify temporal patterns of falls in relation to specific intrinsic and extrinsic risk factors among hospitalized older people; as well as the levels of fatigue/sleepiness, attention and cognitive functionality of the health professionals who attend to an in-hospital fall.
  • A second step, of application of a multidimensional prevention program for 15 months focused on organizational, educational and behavioral elements; applied to admitted older people and health professionals.

Phase 2. Retrospective study of the fall records found in the institutional databases of the study centers, in the period between January 2018 - September 2020. This period covers the first (January 2018 - May 2019) and the second phase (June 2019 - September 2020) of the project, previously indicated.

Phase 3. Descriptive exploratory study with a qualitative approach, focus groups made up of health professionals: doctors, nurses and nursing assistants who provide and have provided their professional services in the field of study, in the periods in which the studies have been carried out. longitudinal and retrospective previously mentioned.

Study Type

Observational

Enrollment (Actual)

200

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Córdoba, Spain, 14004
        • Maimónides Biomedical Research Institute of Córdoba

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

65 years and older (OLDER_ADULT)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Patients over 65 years who suffer one/several fall/s during their hospital admission to four hospital (one teaching and three non-teaching hospitals)

Description

Inclusion Criteria in patients:

  • Patients who suffer a hospital fall
  • Accept and sing the informed consent

Exclusion Criteria in patients:

  • Do not accept and sign the informed consent

Inclusion Criteria in healthcare professionals:

  • Nurses in charge of the care of patients who suffer a fall
  • Accept and sing the informed consent

Exclusion Criteria in patients:

  • Nurses who do not care for a patient suffering a fall
  • Do no accept and sign the informed consent

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Chronoprevention in hospital falls
Implementation of a hospital preventive measures program: adjusted to the identification of temporal patterns of falls and relative risk factors of falls.
Preventive measures will be focused on organizational, educational and behavioural elements related to older people and healthcare professionals

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Participant with Hospital falls
Time Frame: Through study completion, an average of 1 month
Records of falls coded in the International Classification of Diseases (ICD-10) between codes W00-W19.9
Through study completion, an average of 1 month

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Chronotype of patient
Time Frame: Through study completion, an average of 1 month
Morningness-Eveningness according to Horne-Östberg Questionnaire (1976). Scores can range from 18-86. Scores of 41 and below indicate "evening types". Scores of 59 and above indicate "morning types". Scores between 42 and 58 indicate "intermediate types".
Through study completion, an average of 1 month
Quality of life of patient
Time Frame: Through study completion, an average of 1 month
Short Form 36 Health Survey (SF-36) (Spanish version 2) (Alonso et al. 1996). The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability.
Through study completion, an average of 1 month
General health status of patient
Time Frame: Through study completion, an average of 1 month
28-Item General Health Questionnaire (GHQ28) (Spanish version) (Lobo et al. 1985). Scores can range from 0-84. Higher GHQ-28 scores indicate higher levels of distress
Through study completion, an average of 1 month
Sleep pattern of the healthcare professionals
Time Frame: Through study completion, an average of 1 month
Pittsburgh Sleep Quality Index (Spanish version) (Macías & Royuela, 1996). Score can range from 0-21 with the higher total score indicating worse sleep quality.
Through study completion, an average of 1 month
Chronotype of the healthcare professionals
Time Frame: Through study completion, an average of 1 month
Chronotype according to Horne-Östberg Questionnaire (1976). Scores can range from 18-86. Scores of 41 and below indicate "evening types". Scores of 59 and above indicate "morning types". Scores between 42 and 58 indicate "intermediate types".
Through study completion, an average of 1 month
Quality of life of the healthcare professionals
Time Frame: Through study completion, an average of 1 month
Short Form 36 Health Survey (SF-36) (Spanish version 2) (Alonso et al. 1996). The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability.
Through study completion, an average of 1 month
General health status of the healthcare professional
Time Frame: Through study completion, an average of 1 month
28-Item General Health Questionnaire (GHQ28) (Spanish version) (Lobo et al. 1985). Scores can range from 0-84. Higher GHQ-28 scores indicate higher levels of distress
Through study completion, an average of 1 month

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Pablo Jesús López Soto, PhD, Maimónides Biomedical Research Institute of Córdoba

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2018

Primary Completion (Actual)

September 1, 2020

Study Completion (Actual)

June 1, 2022

Study Registration Dates

First Submitted

April 23, 2020

First Submitted That Met QC Criteria

April 25, 2020

First Posted (Actual)

April 29, 2020

Study Record Updates

Last Update Posted (Actual)

October 13, 2022

Last Update Submitted That Met QC Criteria

October 11, 2022

Last Verified

October 1, 2022

More Information

Terms related to this study

Other Study ID Numbers

  • PI-0360-2017

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • ICF

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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