Patient Perspectives on Hospital Falls Prevention Education

Heng, Hazel; Slade, Susan C; Jazayeri, Dana; Jones, Cathy; Hill, Anne‐Marie; Kiegaldie, Debra; Shorr, Ronald I.; Morris, Meg E.

doi:10.3389/fpubh.2021.592440

Cited by 27 publications

(46 citation statements)

References 55 publications

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“…At an organisational level, hospital staff working on patient safety are interested in what works locally to produce sustained reductions in falls in addition to considering the gold-standard evidence afforded by global systematic reviews and meta-analyses [ 80 ]. In this regard education is arguably a powerful tool, although it is not clear which elements of educational design and delivery have the most optimal effects [ 7 , 81 ]. The falls intervention taxonomy that we used differed to a small extent from Lamb [ 82 ], limiting direct comparisons with the prior Cochrane review.…”

Section: Discussionmentioning

confidence: 99%

Interventions to reduce falls in hospitals: a systematic review and meta-analysis

et al. 2022

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Background Falls remain a common and debilitating problem in hospitals worldwide. The aim of this study was to investigate the effects of falls prevention interventions on falls rates and the risk of falling in hospital. Design Systematic review and meta-analysis. Participants Hospitalised adults. Intervention Prevention methods included staff and patient education, environmental modifications, assistive devices, policies and systems, rehabilitation, medication management and management of cognitive impairment. We evaluated single and multi-factorial approaches. Outcome measures Falls rate ratios (rate ratio: RaR) and falls risk, as defined by the odds of being a faller in the intervention compared to control group (odds ratio: OR). Results There were 43 studies that satisfied the systematic review criteria and 23 were included in meta-analyses. There was marked heterogeneity in intervention methods and study designs. The only intervention that yielded a significant result in the meta-analysis was education, with a reduction in falls rates (RaR = 0.70 [0.51–0.96], P = 0.03) and the odds of falling (OR = 0.62 [0.47–0.83], P = 0.001). The patient and staff education studies in the meta-analysis were of high quality on the GRADE tool. Individual trials in the systematic review showed evidence for clinician education, some multi-factorial interventions, select rehabilitation therapies, and systems, with low to moderate risk of bias. Conclusion Patient and staff education can reduce hospital falls. Multi-factorial interventions had a tendency towards producing a positive impact. Chair alarms, bed alarms, wearable sensors and use of scored risk assessment tools were not associated with significant fall reductions.

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Section: Discussionmentioning

confidence: 99%

Interventions to reduce falls in hospitals: a systematic review and meta-analysis

et al. 2022

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“…Similar health behaviour changes through patient empowerment have also been identified by Joseph-Williams et al [ 79 ] and Michie et al [ 80 ]. As with Heng’s trial on patient perspectives [ 74 ], the health professionals in the current study identified frequent and consistent provision of patient education to be a key determinant of hospital falls. Likewise, in the design of future interventions, there is a need to consider initiatives that focus on improving collaboration and teamwork, along with being more patient-centred and tailoring educational materials to individual needs.…”

Section: Discussionmentioning

confidence: 51%

“…Inconsistencies in clinical practice was a major barrier, as with previous reports [ 41 – 43 ]. Heng et al [ 44 ] reported inconsistencies in falls education, content and delivery which limited the ability of patients to understand their risk of falling during an admission. Time constraints and lack of staffing capacity and resources were other challenges, in agreement with Ackerman et al [ 45 ], Keyworth et al [ 43 ] and Svavarsdóttir et al [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Patient-centred factors also need to be taken into consideration. Patients may not always be aware of their falls risk or changes in mobility despite receiving falls education [ 73 , 74 ]. They can also have a fear of embarrassment or a reluctance to burden staff, or have a false sense of security that adversely affects adherence to recommended strategies [ 22 , 75 ].…”

Section: Discussionmentioning

confidence: 99%

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Healthcare professional perspectives on barriers and enablers to falls prevention education: A qualitative study

et al. 2022

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In hospitals, patient falls prevention education is frequently delivered by nurses and allied health professionals. Hospital falls rates remain high globally, despite the many systems and approaches that attempt to mitigate falling. The aim of this study was to investigate health professional views on the enablers and barriers to providing patient falls education in hospitals. Four focus groups with 23 nursing and allied health professionals were conducted at 3 hospitals. Three researchers independently coded the data and findings were analysed thematically with a descriptive qualitative approach to identify and develop themes according to barriers and enablers. Barriers included (i) limited interprofessional communication about patient falls; (ii) sub-optimal systems for falls education for patients and health professionals, and (iii) perceived patient-related barriers to falls education. Enablers to providing patient falls education included: (i) implementing strategies to increase patient empowerment; (ii) ensuring that health professionals had access to effective modes of patient education; and (iii) facilitating interprofessional collaboration. Health professionals identified the need to overcome organisational, patient and clinician-related barriers to falls education. Fostering collective responsibility amongst health professionals for evidence-based falls prevention was also highlighted.

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“…Understanding patients’ views of their fall risk may inform fall prevention policies in hospital settings. For example, Heng, Slade [ 6 ] explored patients’ perceptions of fall prevention education in hospital, revealing that most inpatients did not recognise that they were at risk. This is consistent with other studies that also identified that a lack of insight resulted in a greater risk of falling and reduced adherence to fall prevention strategies [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Adult Inpatients’ Perceptions of Their Fall Risk: A Scoping Review

et al. 2022

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Patient falls in hospitals continue to be a global concern due to the poor health outcomes and costs that can occur. A large number of falls in hospitals are unwitnessed and mostly occur due to patient behaviours and not seeking assistance. Understanding these patient behaviours may help to direct fall prevention strategies, with evidence suggesting the need to integrate patients’ perspectives into fall management. The aim of this scoping review was to explore the extent of the literature about patients’ perceptions and experiences of their fall risk in hospital and/or of falling in hospital. This review was conducted using a five-stage methodological framework recommended by Arksey and O’Malley. A total of nine databases were searched using key search terms such as “fall*”, “perception” and “hospital.” International peer-reviewed and grey literature were searched between the years 2011 and 2021. A total of 41 articles, ranging in study design, met the inclusion criteria. After reporting on the article demographics and fall perception constructs and measures, the qualitative and quantitative findings were organised into five domains: Fall Risk Perception Measures, Patients’ Perceptions of Fall Risk, Patients’ Perceptions of Falling in Hospital, Patients’ Fear of Falling and Barriers to Fall Prevention in Hospital. Approximately two-thirds of study participants did not accurately identify their fall risk compared to that defined by a health professional. This demonstrates the importance of partnering with patients and obtaining their insights on their perceived fall risk, as this may help to inform fall management and care. This review identified further areas for research that may help to inform fall prevention in a hospital setting, including the need for further research into fall risk perception measures.

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Patient Perspectives on Hospital Falls Prevention Education

Cited by 27 publications

References 55 publications

Interventions to reduce falls in hospitals: a systematic review and meta-analysis

Interventions to reduce falls in hospitals: a systematic review and meta-analysis

Healthcare professional perspectives on barriers and enablers to falls prevention education: A qualitative study

Adult Inpatients’ Perceptions of Their Fall Risk: A Scoping Review

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