{
  "abstract": "Introduction Patient falls in hospitals lead to patient harm, staff distress and economic burden on health systems. There are few strategies with robust evidence demonstrating benefit for the prevention of falls, especially in acute hospital settings. Education and multicomponent fall prevention approaches are promising. Rigorous systematic measurement of implementation has been lacking in most hospital fall prevention trials. This paper describes the protocol for a trial that will evaluate the impact of supported implementation of tailored multicomponent fall prevention interventions on patient falls in hospital.Methods and analysis A stepped-wedge hybrid type I effectiveness implementation cluster randomised trial will be conducted. Twelve inpatient wards across four metropolitan hospitals will be enrolled in the trial, clustered into groups of four and randomised to commence the intervention at one of three time periods. Patients and ward staff will be recruited to complete pre-implementation surveys, which, combined with analysis of routinely collected local falls data and staff brainstorming, will inform tailored multicomponent fall prevention interventions for each ward. Wards will receive quality improvement training, clinical facilitation and staff education for at least 4 months to support implementation of their fall prevention interventions. The primary outcome—rate of falls—will be measured using routinely collected hospital falls data from the incident management system and medical records. Pre-implementation and post-implementation patient and staff surveys, qualitative interviews and bedside audits will measure secondary effectiveness and implementation outcomes. Healthcare utilisation from hospital data will inform the cost-effectiveness analysis.Ethics and dissemination The Sydney Local Health District Human Research Ethics Committee (RPAH Zone) approved this trial (protocol number X24-0087 and 2024/ETH00583). The trial is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12624000896572). Data collection commenced in October 2024, due for completion in May 2026. Results will be published in reputable international journals and presented at relevant conferences.Trial registration number Australian and New Zealand Clinical Trials Registry (ACTRN12624000896572).",
  "authors": [
    {
      "affiliations": [
        "Institute for Musculoskeletal Health, Sydney Local Health District, Camperdown, New South Wales, Australia",
        "School of Public Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"
      ],
      "name": "Charlotte McLennan"
    },
    {
      "affiliations": [
        "School of Public Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia",
        "Sydney Health Partners Implementation Science Academy, Sydney, New South Wales, Australia"
      ],
      "name": "Leanne Hassett"
    },
    {
      "affiliations": [
        "Sydney Local Health District, Camperdown, New South Wales, Australia"
      ],
      "name": "Wendy Tilden"
    },
    {
      "affiliations": [
        "Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia",
        "Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Hospital, Concord Repatriation General Hospital, Concord, New South Wales, Australia"
      ],
      "name": "Vasi Naganathan"
    },
    {
      "affiliations": [
        "Institute for Musculoskeletal Health, Sydney Local Health District, Camperdown, New South Wales, Australia",
        "School of Public Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"
      ],
      "name": "Abby Haynes"
    },
    {
      "affiliations": [
        "Physiotherapy, South Western Sydney Local Health District, Liverpool, New South Wales, Australia"
      ],
      "name": "Matthew Jennings"
    },
    {
      "affiliations": [
        "Aged Care, Liverpool Hospital, Liverpool, New South Wales, Australia",
        "SWS Clinical School, University of New South Wales, Sydney, New South Wales, Australia"
      ],
      "name": "Danielle Ni Chroinin"
    },
    {
      "affiliations": [
        "Institute for Musculoskeletal Health, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Bethan Richards"
    },
    {
      "affiliations": [
        "Sydney Local Health District, Camperdown, New South Wales, Australia"
      ],
      "name": "Andrew Hallahan"
    },
    {
      "affiliations": [
        "School of Health Sciences, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia",
        "Clinical Research Centre, Sydney Local Health District, Camperdown, New South Wales, Australia"
      ],
      "name": "Raaj Kishore Biswas"
    },
    {
      "affiliations": [
        "Institute for Musculoskeletal Health, Sydney Local Health District, Camperdown, New South Wales, Australia",
        "School of Public Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"
      ],
      "name": "Wing Kwok"
    },
    {
      "affiliations": [
        "Sydney Local Health District, Camperdown, New South Wales, Australia"
      ],
      "name": "Tamsin McVeigh"
    },
    {
      "affiliations": [
        "Sydney Local Health District, Camperdown, New South Wales, Australia"
      ],
      "name": "Erica Heppleston"
    },
    {
      "affiliations": [
        "Susan Wakil School of Nursing and Midwifery, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"
      ],
      "name": "Debra Jackson"
    },
    {
      "affiliations": [
        "Institute for Musculoskeletal Health, Sydney Local Health District, Camperdown, New South Wales, Australia",
        "School of Public Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"
      ],
      "name": "Veethika Nayak"
    },
    {
      "affiliations": [
        "Sydney Local Health District, Camperdown, New South Wales, Australia"
      ],
      "name": "Sally Delaney"
    },
    {
      "affiliations": [
        "School of Public Health, University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Kirsten Howard"
    },
    {
      "affiliations": [
        "Institute for Musculoskeletal Health, Sydney Local Health District, Camperdown, New South Wales, Australia",
        "School of Public Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"
      ],
      "name": "Marina Pinheiro"
    },
    {
      "affiliations": [
        "South Western Sydney Local Health District, Liverpool, New South Wales, Australia"
      ],
      "name": "Amanda Macpherson"
    },
    {
      "affiliations": [
        "Consumer Investigator, Sydney, New South Wales, Australia"
      ],
      "name": "Jenny Rayner"
    },
    {
      "affiliations": [
        "School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia",
        "WA Centre for Healthy Ageing, The University of Western Australia, Perth, Western Australia, Australia"
      ],
      "name": "Anne-Marie Hill"
    },
    {
      "affiliations": [
        "Monash University School of Primary and Allied Health Care, Frankston, Victoria, Australia"
      ],
      "name": "Terry Haines"
    },
    {
      "affiliations": [
        "Institute for Musculoskeletal Health, Sydney Local Health District, Camperdown, New South Wales, Australia",
        "School of Public Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"
      ],
      "name": "Catherine Sherrington"
    }
  ],
  "title": "Supported implementation of tailored hospital fall prevention interventions: a protocol for the PROTECT stepped wedge type I hybrid effectiveness-implementation trial",
  "uid": "04766a54-fcec-5c7f-8aa7-95121a3db157"
}