Translation of falls prevention knowledge into action in hospitals: what should be translated and how should it be done?

Introduction

Falls prevention evidence has changed and evolved over time with positive and negative studies revealing that a “one-size fits all” approach is not the solution. Care must be taken to critically appraise the evidence and the potential applicability of that evidence to the specific hospital setting.

Method

A narrative account of the evolution of research evidence in this field is first presented. How this evidence should be applied in clinical practice is challenging, with a lack of translational evidence for the hospital setting we draw on broader theory of translating knowledge to action.

Conclusions

The journey should begin with formation of a management and engagement committee. A review of existing practices and the difference between existing practice and evidence-based practice should be undertaken to identify the “evidence-practice gap.” Engagement with staff is recommended to inform a plan for practice change. Plans for resourcing, targeting, and evaluating these strategies should also be undertaken.

Impact on Industry

This paper will assist hospitals to identify and implement evidence based falls prevention strategies leading to an improvement in patient safety.     

Continued progress in the prevention of nail gun injuries among apprentice carpenters: What will it take to see wider spread injury reductions?

Problem

Nail guns are a common source of acute, and potentially serious, injury in residential construction.

Method

Data on nail gun injuries, hours worked and hours of tool use were collected in 2008 from union apprentice carpenters (n = 464) through classroom surveys; this completed four years of serial cross-sectional data collection from apprentices. A predictive model of injury risk was constructed using Poisson regression.

Results

Injury rates declined 55% from baseline measures in 2005 with early training and increased use of tools with sequential actuation. Injury rates declined among users of tools with both actuation systems, but the rates of injury were consistently twice as high among those using tools with contact trip triggers.

Discussion and impact

Nail gun injuries can be reduced markedly through early training and use of tools with sequential actuation. These successful efforts need to be diffused broadly, including to the non-union sector.     

What does team–member exchange bring to the party? A meta‐analytic review of team and leader social exchange

Both leader–member exchange (LMX) and team–member exchange (TMX) measure the quality of reciprocal exchange among employees in the workplace. Although LMX focuses on supervisor–subordinate relationships while TMX examines the relationships among team members, both have theory‐based and empirically proven relations with workplace outcomes such as job performance, organizational commitment, job satisfaction, and turnover intentions. However, it is not yet known which has more of an impact on such workplace outcomes—specifically, it is not clear if an employee's time is best spent developing vertical relationships among supervisors and subordinates (LMX) or on the horizontal relationships among team members (TMX). Accordingly, this meta‐analysis explores the incremental validity and relative importance of these two social exchange‐based constructs. The theoretical logic underlying LMX and TMX is clarified, and the parameter estimates between LMX, TMX, and work outcomes are reported. Results demonstrate that TMX shows incremental validity above and beyond LMX for some outcomes (organizational commitment and job satisfaction), but not others (job performance and turnover intentions). Also, LMX shows greater relative importance across all four outcomes. In sum, the clarification of the theoretical and empirical landscape lays a foundation for recommendations for future research. Copyright © 2013 John Wiley & Sons, Ltd.