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

Abstract

Rationale, Aims, and Objectives: Patient sitters provide one-to-one care for hospital patients at high risk of falls. The study aimed to explore patient sitters' task readiness to assist in fall prevention on hospital wards. Method:We conducted a cross-sectional survey. Respondents were patient sitters working in five hospitals providing medical, surgical, and aged care. The survey was developed using a theory of health behaviour change and used closed and openended items. Qualitative data were analysed using deductive content analysis.Results: Participants (n = 90) identified that patient factors, such as confusion, were the most frequent cause of falls (n = 338, 74%); however, the most frequent strategies identified to prevent falls were focused on the environment (n = 164, 63%). The most frequent barrier participants identified to preventing falls (n = 124, 67%) also pertained to patients, including aggressive patient behaviours. In contrast, staff factors, such as handovers being adequate, were identified as the main enabler for sitters being able to complete their tasks effectively (n = 60, 81%). Participants strongly suggested (71%) that further, preferably practical, training would be helpful, even though 84% reported receiving prior fall prevention training. Nearly all participants (98%) were motivated to prevent their patients from falling. Conclusions:There is a gap between what patient sitters report as the cause of falls (patient factors) and what was suggested to prevent falls (environment factors). Education and practical training addressing challenging patient behaviours may improve sitters' task readiness to assist in preventing falls on wards. Improving communication and cooperation between patient sitters and nursing staff is also important.

Effect of nurses' resilience on fall prevention in acute‐care hospital: A mixed‐methods qualitative study

“…Data from the United States estimate that 700,000 to 1 million patient falls occur in U.S. hospitals annually (LeLaurin & Shorr, 2019); an average of 6.63 falls per 1,000 occupied bed days were reported in the UK (Morris & O'Riordan, 2017); and an average of 33,000 annual fall events—in Australia (Australian Institute of Health & Welfare, 2016). Yet, despite repeated warnings that inpatients' falls represent a major threat to patient safety, their frequency has not decreased (de Jong et al., 2020). Nurses can play a significant role in fall prevention through their regular attendance during 24 hr and consistent contact with patients (King et al., 2018).…”

The impact of COVID-19 on patient safety attendant use

“…15 , 17 , 20 , 21 , 23 , 24 Some studies have shown that PSAs have not received adequate fall prevention training. 14 , 19 , 21 The PSA often does not perform interventions to address the root cause of the problem, such as delirium. Video monitoring, specifically the use of portable cameras with a speaker and a trained technician to directly observe patients from a remote location, serves as an alternative to the PSA.…”

“…PSAs, also known as sitters or observation assistants, provide constant direct observation of patients who have cognitive impairments or thoughts of harming themselves or others. [12][13][14][15][16] These patients may experience hallucinations, psychosis, agitation, confusion, impulsiveness, restlessness, disorientation, or delirium, or they may be inclined to remove medical devices such as I.V. lines and catheters.…”

“…Although a decline in falls has been attributed to PSAs, most studies have shown that a reduction in PSAs does not increase or decrease fall rates 15,17,20,21,23,24. Some studies have shown that PSAs have not received adequate fall prevention training 14,19,21. The PSA often does not perform interventions to address the root cause of the problem, such as delirium.…”

“Specialling” and “Sitters”: What does communication between registered nurses and unregulated workers reveal about care?

“…This passive watching role may contribute to an inability to affect real safety outcomes. For example, although AINs in one study perceived falls to be caused by patient behaviour and confusion, they only focussed on decluttering the environment for safety, rather than reducing the risk of falling through enacting individualised psychosocial strategies for reducing stress in the patient and subsequently the severity of their BPS ( de Jong, Weselman, Kitchen, & Hill, 2019 ).…”