Design and feasibility of a digital application to assess and document falls in residential aged care: a mixed methods study

Falls among older adults living in residential aged care have significant health and economic consequences, however assessment and documentation practices are often inconsistent. Technology may offer a solution to addressing these inconsistencies. This study evaluates the feasibility of using a digital application (app) to support the assessment and documentation of falls. The specific aims of the study were to review the thoroughness of post fall documentation prior to and when using the app and understand the perspectives of care staff regarding the app and falls assessment and documentation more generally. This study used a mixed-method design and included: file audit of falls documentation before and after use of the app (over 3-months), a staff survey on falls reporting procedures and an app usability assessment via the System Usability Scale (SUS). Data analyses consisted of descriptive statistics and content analyses. Falls documentation was more adherent to guidelines when using the app compared with usual practice overall (19% increase) and across five out of seven audit subcategories (review of 165 falls). Improvements were seen in documentation of fracture screening (43% improvement) and neurological observations (51% improvement). The staff survey had a 56% response rate and 90% completion rate (n = 10); care staff reported being able to assess (89%) and document (63%) a fall in 30 min or less. Most care staff (70%) were confident in their abilities to assess a fall. The app demonstrated good usability with a mean (SD) SUS score of 70 (12). This study has demonstrated the feasibility of using an app for falls assessment and documentation in residential aged care and can increase adherence to documentation guidelines. The promising results suggest further evaluation of digital tools for falls assessment and documentation are warranted.