Exploring falls prevention capabilities, barriers and training needs among patient sitters in a hospital setting: A pilot survey

Abstract

Older patients in hospitals are at high risk of falls. Patient sitters are sometimes employed to directly observe patients to reduce their risk of falling although there is scant evidence that this reduces falls. The primary aim of this pilot survey (n = 31) was to explore the patient sitters' falls prevention capability, self-efficacy and the barriers and enablers they perceived influenced their ability to care for patients during their shifts. Feedback was also sought regarding training needs. Most (90%) participants felt confident in their role. The most frequent reasons for falls identified were patient-related (n = 91, 64%), but the most frequent responses identifying preventive strategies were environment-related (n = 54, 64%), suggesting that the sitters' capability was limited. The main barriers identified to keeping patients safe from falling were patient-related (n = 36, 62%) such as cognitive impairment. However, opportunities that would enable sitters to do their work properly were most frequently categorized as being staff-related (n = 20, 83%), suggesting that the sitters have limited ability to address these barriers encountered. While 74% of sitters reported they had received previous training, 84% of participants would like further training. Patient sitters need more training, and work practice needs to be standardized prior to future research into sitter use for falls prevention.

Evaluation of care staff knowledge, confidence, motivation and opportunity for preventing falls in residential aged care settings: A cross‐sectional survey

“…These findings confirm those of our feasibility study (Hang et al, ) and are supported by other studies conducted amongst care staff in hospitals who looked after older patients at risk of falls (Clancy & Mahler, ; de Jong, Kitchen, Foo, & Hill, ). This study also had a larger sample size and was conducted at multiple facilities.…”

Exploring hospital patient sitters' fall prevention task readiness: A cross‐sectional survey

“…The study was conducted using a cross‐sectional survey. The survey was pilot tested prior to this study for its feasibility to use in hospital settings, including evaluating the deductive analytic framework prior to conducting the larger survey …”

“…Inclusion criteria were as follows: (1) The sitter was providing one‐to‐one supervision for a high fall risk patient, (ii) had completed at least one sitter shift in the 12 months prior to recruitment, and (iii) was able to comprehend English sufficiently to complete the survey. Sitters who had participated in the pilot survey conducted prior to the present study were excluded from participation. The surveys were conducted between June 2017 and June 2018.…”

“…The theory used to inform this study was the health behaviour change framework: COM‐B (Capability, Opportunity and Motivation = Behaviour) . The survey was developed and subsequently tested in a pilot study described previously . For the present study, the survey was amended to include a question about motivation and collect more information about the patient sitters' background and training needs.…”

“…This approach was taken using an explanatory matrix (see Table S1) that conceptualized mechanisms for falls. This matrix, tested during the pilot survey, was based on the COM‐B behaviour change model and previous research, which has outlined a framework conceptualizing why falls occur in hospital . In brief, this framework explains that effective interaction between key domains of patient actions, staff actions, and the environment is critical to reduce the risk of patients falling.…”