Table 1 6-PACK implementation protocol (strategies for implementation of the 6-PACK program on intervention wards)

Resources

Hospital

Appointment of an executive sponsor (type not specified)

Provision of 6-PACK falls prevention program equipment^a:

• ‘Falls alert’ signs^b. One for each inpatient ward bed.

• Low-low beds (to be able to be lowered 250 mm from the floor level or lower). A minimum of 1 low-low bed to 3 standard beds on medical wards and 1 low-low bed to 10 standard beds on surgical wards.

• Bed/chair alarms. Three on medical wards and one on surgical wards.

Appointment of a part-time falls prevention site clinical leader^c for the 12 month study period. Recommended 0.1 Full Time Equivalent (FTE) for each intervention ward.

Ward

Appointment of two nurses from current permanent staff to act as ward champions to support the site clinical leader and the local assimilation of the 6-PACK program.

Activities

Hospital

Integration of the 6-PACK program documentation (risk tool and interventions) into the daily care-plan

Site clinical leader

Attend small interactive face-face group training sessions provided by the research team which included training on the use of the 6-PACK program, leadership, education and change management and provision of a implementation and training guide (two one day sessions, one prior to program implementation and one refresher 6-months post implementation).

Develop a ‘ReadySetGo’ 6-PACK implementation plan tailored to the hospital and participating wards.

Deliver small interactive group training sessions to nurses on intervention wards on the use of the 6-PACK program and documentation. Training sessions were based on material provided by the research team but tailored to the needs of the ward by the site clinical leader. A review of site specific case studies were also encouraged. Minimum of two training sessions to be delivered per ward.

Attend monthly site clinical leader network teleconference meetings with the research team to discuss implementation progress and trouble-shoot implementation challenges (approximately 1 h in length).

Communicate to ward staff (ward nurses, ward champions and Nurse Unit managers) monthly to provide data on fall event outcomes, risk assessment completion and program adherence.

Undertake 15-min ward ‘walk rounds’ with ward staff and champions that utilize bedside audit, reminders and feedback:

• Weekly for the first month;

• Fortnightly for the next 5-months; and

• Monthly for the final 6-months.

Wards

Provide monthly data extract reports from the hospital incident reporting database for all participating wards as part of the feedback loop.

Ward nurses attend 6-PACK program education sessions run by the site clinical leader.

Ward champions/Nurse Unit managers undertake monthly compliance audits on the use of 6-PACK documentation and nurse’s adherence to the 6-PACK program.