Hospital falls persist as a major threat to patient safety. This study aimed to develop an interprofessional reference standard to prevent, manage and report hospital falls.

A Delphi consensus methodology, informed by the Conducting and Reporting Delphi Studies guideline, was used to design the reference standard. An interprofessional expert panel (n=47) of health professionals, researchers, policymakers and consumers participated in three Delphi rounds. Following the review of clinical guidelines, an e-Delphi survey was developed and piloted to derive 60 initial items for the standard. Two iterative rounds of e-Delphi surveys were distributed via Research Electronic Data Capture and included free-text questions and 9-point Likert scales. An online consensus meeting followed, to ratify the final standard.

In the first Delphi round, there was over 80% agreement for 44/60 items to be included in the reference standard. This increased to 48/60 items in Round 2. At the final consensus meeting, 12 items still did not reach consensus for inclusion and one was added, yielding 49 items. Items that replicated text according to falls with injury/without injury were combined, resulting in 42 items in the final reference standard. Agreed items included: (1) brief screening of falls risk on hospital admission; (2) comprehensive falls assessment for inpatients who are older, frailer or have complex conditions; (3) single interventions (such as environmental adaptations and exercise); (4) multifactorial interventions; (5) education of patients, families and staff; (6) optimising local falls hospital policies, procedures and leadership capability; (7) optimising documentation and reporting; (8) improving accreditation processes; (9) workforce redesign to augment falls education. Items that did not reach agreement (n=12) pertained to alarms, bed rails, grip socks, artificial intelligence, volunteers and care bundles.

This new reference standard provides a checklist for staff, patients, managers and policymakers to reduce unwanted variations in prevention, management and reporting of hospital falls.

ANZCTR 386960

Advanced maternal age (AMA), defined as giving birth at age 35 or older, is an increasingly significant public health concern worldwide. This study aimed to identify the socio-demographic and economic determinants of giving birth at AMA among women in Ethiopia and to explore the resulting health consequences for both mothers and children.

This study is a secondary analysis of data from 5517 women extracted from the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS), a nationally representative cross-sectional survey. The data were cleaned, weighted using STATA V. 17 and analysed using ArcGIS 10.8 to map AMA. Global and local Moran’s Index methods were used to assess clustering and a multilevel binary logistic regression model was fitted to identify predictors of giving birth at AMA.

The prevalence of giving birth at AMA was 12.7%, with a Global Moran’s I of 0.9964, indicating significant clustering across Ethiopian zones (p

This study found a high prevalence of giving birth at AMA among women with a lifetime birth history, with a spatially non-random distribution, indicated by a positive Moran’s Index. Individual and community-level factors such as having a previous male child, small family size, being Catholic or Protestant and residing in Addis Ababa or the Amhara region were positively associated with AMA. Conversely, factors including lower education level (no or primary education), contraceptive use, media access, rural residence adherence to postnatal check-ups and residing in the Afar region were negatively associated with AMA. All community-level factors were significantly associated with the outcome.