The Development of Practice Guideline for Preventing Fall Using 10 P’s Multifactorial Concepts among Older Adults in Community

Abstract

          The aims of this developmental research were  1)To Develop multifactorial of 10 P’s principle of fall prevention guidelines in the older people in  community and 2) To study the effectiveness of the use of multifactorial of 10 P’s principle of fall prevention guidelines in the older people in community. This developed program separated into 3 phases 11 stages by applying conceptual framework from National health and medical research council by the practice development team which was conducted during March 2019 to January 2020. Samples were 2 groups of 42 older people and 21 VHVs. Purposive sampling was specified according to inclusion criteria. There were 2 types of instruments used in this study 1) Multifactorial Fall Prevention Guidelines were checked for content validity by 5 qualified practitioners in each issue, each with a content validity index of 0.8-1. [cvi] = 0.8-1, and 2) the data collection tools were the nursing team effectiveness questionnaire were checked for content validity by 5 qualified practitioners content validity index of 0.8-1 [cvi] = 0.8-1 and the reliability of Cronbach’s alpha of .88 .Data analysis was descriptive statistics, summary report and evaluation of the development of guidelines.

The Results was found as following; Multifactorial of 10 P’s principle of fall prevention guidelines in the older people in community proceeded 4 steps during 4 weeks. The 1^st Week started (1) The workshop for 21 VHVs’ skill in knowledge using risk assessment tool among multifactorial of 10 P’s principle of fall prevention guidelines in the older people in community and assign the VHVs as a nursing team. (2) Assess the risk of falls in the older people in community and classify the older people according to the types of risk. (3) Knowledge Workshop for the older people for stimulate awareness of the risk of falls and activities prevention in the older people according to risk factors classified according to 10 P’s principle of fall prevention guidelines, providing fall prevention manual. And (4) 2^nd week – 4^th week home visit 4 times by a nursing team for healthy home environmental / avoid activities at risk locations, medication intake checking and drug advise , falls prevention knowledge reviewed by using fall prevention manual. The effectiveness of the nursing team regarding the accuracy of knowledge is at a good level (Mean= 20.71 ,SD. = 2.28 ),the respond speed is at very good level ( Mean= 23.23  ,SD. = 1.22 ), the creativity is at a good level ( Mean= 20.14  ,SD. =3.33 ) and the total topic is a good level ( Mean= 64.09  ,SD. = 5.04 ) Conclusion: Multifactorial of 10 P’s principle of fall prevention guidelines in the older people in community is the international standards and a nursing practice guideline applied effectively. In practice, the effectiveness of creative problems was found. The problem is a suitable healthy home environment requires proper budget and manpower, therefore the VHVs are unable to help and stimulate the older people and families at the aspect. Suggestion: The community participation guidelines in falls prevention of the older people in community in order to prevent falls and problems solving should be studied, monitored and evaluated in the long term.