Question

what is the best sampling plan if I am trying to evaulate a health program? I am evaluating whether or not a fall prevention program is helpful to elderly people in my county.

My study design is Cohort

the program last 3 months and I want to follow up with participants after the program is complete

Answer 1

While measuring fall rates is the ultimate test of how your facility or unit is performing, fall rates are limited in that they do not tell you how to improve care. If your fall rate is high, on what specific areas should you focus? To know where to focus improvement efforts, it is important to measure whether key practices to reduce falls are actually happening.

Many important practices could be measured in assessing fall prevention. We recommend initially looking at no more than two, such as:

• Performance of fall risk factor assessment within 24 hours of admission.
• Performance of care planning that addresses each risk factor identified during fall risk factor assessmentSample Protocol for Assessing Performance of Fall Risk Factor Assessment
• Take a sample of records of patients newly admitted to your unit within the past month. For an informal audit, an arbitrary number such as 10 or 20 records may be sufficient for initial assessments of performance. A more formal audit might review 10 percent of all patients admitted to the unit.
• Identify medical and nursing notes from the first 24 hours of hospitalization. These should include the admission nursing assessment, physician's admission note, and subsequent nursing progress notes.
• Determine whether there is any documentation of a fall risk factor assessment. This might include mention of the patient's level of orientation and cognition, gait and balance, continence status, and number and types of prescribed medications, as well as a number of diagnoses.
• Determine whether key findings from the fall risk factor assessment were further explored. For example, if a patient is noted to be disoriented, is there an assessment for delirium (go to Tool 3L)?
• Calculate the percentage of patients having any documentation of a fall risk factor assessment as well as the percentage of cases in which key findings from the fall risk factor assessment were further explored. Good performance on these key processes of care is critical to preventing falls. If you are not doing well, or as well as you would like, in one of these key areas, it provides an opportunity for improvement. Examine what the problem is and plan how to overcome this barrier. For example, are staff engaged in the program? Do they know what they need to do?