Assessing the acceptability of a post-fall toolkit among residential aged-care staff

Unplanned hospital transfers are defined as unexpected visits to an acute care setting, resulting in an emergency department (ED) visit or hospital admission. In Australia, unplanned transfers of older adults residing in residential aged care facilities (RACF) to hospital are rapidly increasing (from 11.8% in 2015 to 14% in 2019) and are associated with serious adverse events for residents, including confusion, pressure injury, infection, increased assistance with daily activities and falls. Falls and fall-related injuries are among the main reasons for ED visits from RACFs without inpatient stays, one-day stays and hospitalisations. Previous research suggests that up to 67% of all RACFs to ED transfers are not necessarily beneficial for residents (i.e., residents do not receive any treatment in the ED) and are thus considered potentially avoidable or inappropriate. Clinical decision support tools (i.e., post-fall assessment pathways or toolkits) aim to improve healthcare delivery by enhancing decision-making through providing targeted health information to residential care staff. In RACFs, decision-making regarding a possible ED transfer is challenging for residential care staff, who might find it difficult to initiate a structured assessment immediately after a fall and to decide whether a hospital transfer is warranted. This proposed project aims to evaluate the acceptability and feasibility of a post-fall toolkit implemented in aged care facilities.