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A qualitative study of the determinants of adherence to NICE falls guideline in managing older fallers attending an emergency department

Overview of attention for article published in International Journal of Emergency Medicine, July 2018
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  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (76th percentile)

Mentioned by

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11 tweeters
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1 Facebook page

Citations

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5 Dimensions

Readers on

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46 Mendeley
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Title
A qualitative study of the determinants of adherence to NICE falls guideline in managing older fallers attending an emergency department
Published in
International Journal of Emergency Medicine, July 2018
DOI 10.1186/s12245-018-0192-9
Pubmed ID
Authors

Helen McEwan, Richard Baker, Natalie Armstrong, Jay Banerjee

Abstract

The National Institute for Health and Care Excellence (NICE) 2004 Falls guideline was developed to improve the assessment and management of falls and prevention of future falls. However, adherence to the guideline can be poor. As emergency departments (EDs) are usually consulted by older adults (aged 65 and over) who experience a fall, they provide a setting in which assessments can be conducted or referrals made to more appropriate settings. The objective of this study was to investigate how falls are managed in EDs, reasons why guideline recommendations are not always followed, and what happens instead. The study involved two EDs. We undertook 27 episodes of observation of healthcare professional interactions with patients aged 65 or over presenting with a fall, supported by review of the clinical records of these interactions, and subsequently, 30 interviews with healthcare professionals. The qualitative analysis used the framework approach. Various barriers and enablers (i.e. determinants of practice) influenced adherence at both EDs, including the following: support from senior staff; education; cross-boundary care; definition of falls; communication; organisational factors; and staffing. A variety of factors influence adherence to the Falls guideline within an ED, and it may be difficult to address all of them simultaneously. Simple interventions such as education and pro-formas are unlikely to have substantial effects alone. However, taking advantage of the influence of senior staff on juniors could enhance adherence. In addition, collaborative care with other NHS services offers a potential approach for emergency practitioners to play a part in managing and preventing falls.

Twitter Demographics

The data shown below were collected from the profiles of 11 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 46 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 46 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 8 17%
Student > Bachelor 7 15%
Student > Master 6 13%
Student > Doctoral Student 3 7%
Unspecified 2 4%
Other 7 15%
Unknown 13 28%
Readers by discipline Count As %
Nursing and Health Professions 9 20%
Medicine and Dentistry 9 20%
Psychology 3 7%
Unspecified 2 4%
Biochemistry, Genetics and Molecular Biology 1 2%
Other 7 15%
Unknown 15 33%

Attention Score in Context

This research output has an Altmetric Attention Score of 8. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 May 2019.
All research outputs
#4,037,952
of 22,952,268 outputs
Outputs from International Journal of Emergency Medicine
#148
of 606 outputs
Outputs of similar age
#78,392
of 328,806 outputs
Outputs of similar age from International Journal of Emergency Medicine
#2
of 4 outputs
Altmetric has tracked 22,952,268 research outputs across all sources so far. Compared to these this one has done well and is in the 82nd percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 606 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.5. This one has done well, scoring higher than 75% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 328,806 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 76% of its contemporaries.
We're also able to compare this research output to 4 others from the same source and published within six weeks on either side of this one. This one has scored higher than 2 of them.