{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:21:32Z","timestamp":1777922492766,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100013374","name":"NIHR School for Primary Care Research","doi-asserted-by":"publisher","award":["613"],"award-info":[{"award-number":["613"]}],"id":[{"id":"10.13039\/501100013374","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Palliat Care"],"abstract":"\n Background<\/jats:title>\n Falls are a significant challenge in inpatient hospices, with serious consequences including injury, loss of confidence, prolonged admissions, and reduced quality of life. The Action Falls Programme, a multifactorial falls prevention intervention, has proven effective in UK care homes. However, hospice patients present distinct risks related to their complex, palliative care needs, necessitating adaptation of the checklist for this setting.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To adapt and refine the Action Falls checklist for use in inpatient hospices by achieving expert consensus on the relevance and appropriateness of individual risk and action items.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A modified RAND\/UCLA Appropriateness Method was used across 3 iterative rounds involving 14 hospice professionals from 4 UK hospices. Round 1 involved rating risk and action items on a 9-point Likert scale. Items with low agreement were taken forward to a facilitated online focus group for discussion and refinement. A final survey assessed appropriateness and necessity of the revised checklist.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Consensus was achieved on a revised hospice-specific checklist comprising 21 risk items and 34 actions, covering 6 domains: History, Behaviour, Intake, Intrinsic, Mobility, and Environment. Key adaptations included shortening the timeframe for fall history, removing redundant references to general practitioners and external referrals, and shifting emphasis from nutrition to hydration. Environmental risks like flooring and temperature were removed due to limited relevance. Patient-centred concerns, including fatigue, continence, and fluctuating mobility, informed the revised actions.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The Action Falls checklist can be adapted for inpatient hospice settings, reflecting the unique needs and care context of this population. The adapted checklist achieved expert consensus and is now suitable for feasibility testing. Further research is needed to evaluate its effectiveness in reducing falls within hospices.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/08258597261421297","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T17:43:05Z","timestamp":1771609385000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Adaption of the Action Falls Multifactorial Checklist for Inpatient Palliative Care (AAFPC): A RAND-UCLA Consensus Study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7265-0676","authenticated-orcid":false,"given":"Fran","family":"Allen","sequence":"first","affiliation":[{"name":"University of Nottingham"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trudi","family":"Cameron","sequence":"additional","affiliation":[{"name":"University of Nottingham"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pip","family":"Logan","sequence":"additional","affiliation":[{"name":"University of Nottingham"},{"name":"University of Queensland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"National Institute for Health and Care Excellence. What Is Palliative Care? NICE. Accessed September 26 2024. https:\/\/cks.nice.org.uk\/topics\/palliative-care-general-issues\/"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.12968\/ijpn.2011.17.2.75"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216318776846"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afac205"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.12968\/bjcn.2010.15.8.76117"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2021-066991"},{"key":"e_1_3_2_8_2","unstructured":"NHS England. Proactive Care for People Living in Care Homes. NHS England; 2023. Accessed December 12 2025. https:\/\/www.england.nhs.uk\/long-read\/providing-proactive-care-for-people-living-in-care-homes-enhanced-health-in-care-homes-framework\/"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/02692163221127808"},{"key":"e_1_3_2_10_2","unstructured":"Fitch K Bernstein SJ Aguilar MD et al. The RAND\/UCLA Appropriateness Method User\u2019s Manual. RAND Corporation; 2001. https:\/\/www.rand.org\/pubs\/monograph_reports\/MR1269.html"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216310373163"},{"key":"e_1_3_2_13_2","unstructured":"National Institute for Health and Care Excellence. Falls: Assessment and Prevention in Older People and in People 50 and Over at Higher Risk. NICE; 2025. Accessed December 20 2025. https:\/\/www.nice.org.uk\/guidance\/ng249"},{"key":"e_1_3_2_14_2","unstructured":"Gow J McManus E Mackay M. Falls Prevention and Management in a Hospice In-Patient Unit: Evidencing Best Practice and Documentation. 2015. Accessed December 15 2025. https:\/\/www.palliativecarescotland.org.uk\/content\/publications\/16.-Falls-Prevention-and-Management-in-a-hospice-in-patient-unit.pdf"},{"issue":"1","key":"e_1_3_2_15_2","article-title":"Hospice in-patient unit: Improving falls management","volume":"7","author":"Ingham R","year":"2017","unstructured":"Ingham R, Brash J, Fletcher A, et al. Hospice in-patient unit: Improving falls management. BMJ Support Palliat Care. 2017;7(suppl 1):A58.","journal-title":"BMJ Support Palliat Care"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2021-003093"}],"container-title":["Journal of Palliative Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08258597261421297","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08258597261421297","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08258597261421297","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T20:21:48Z","timestamp":1777666908000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08258597261421297"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,20]]},"references-count":15,"alternative-id":["10.1177\/08258597261421297"],"URL":"https:\/\/doi.org\/10.1177\/08258597261421297","relation":{},"ISSN":["0825-8597","2369-5293"],"issn-type":[{"value":"0825-8597","type":"print"},{"value":"2369-5293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,20]]},"article-number":"08258597261421297"}}