The efficacy of an educational program to improve direct caregiver knowledge regarding fall prevention

Opinions of Nurses About the Evaluation of Risk of Falling Among Inpatients

BACKGROUND

Patient falls and fall-related injuries are an important problem for patients, relatives, caregivers, and the health system at large.

AIMS

This study aims to identify opinions of nurses about the risk of falling among patients staying in hospitals.

METHOD

This study uses a qualitative descriptive design and employs a semistructured interview method to identify the opinions and experiences of nurses about patient falls. This study evaluated the opinions of a total of 12 staff nurses.

FINDINGS

It was found that nurses consider patients in the postoperative period to be most prone to falls. They think that most falls take place during transfers and that the medical diagnosis of the patient plays a crucial role in fall incidents. The most important problem associated with patient falls was symptoms of traumatic brain injury. According to the participating nurses, the risk of fall for every patient should be evaluated upon admission. Measures that the nurses take against patient falls include raising the bed's side rails and securing the bed brakes.

CONCLUSIONS

The findings of this research suggest that in-service training programs about the evaluation of the risk of falling should be organized for nurses. Guidelines should be developed for patients with different levels of risk of falling. It is suggested that nurses should be in charge of training patients who are conscious, their relatives, and caregiver personnel.

CLINICAL RELEVANCE

The training of nurses and caregivers helps to prevent the falls of inpatients.

Effectiveness of a fall awareness and education program in acute care

The impact of a patient fall can have serious consequences for the patient, the family, and the healthcare institution. More than half of patient falls are considered preventable. This article reflects the outcomes of a quasi-experimental study to determine the effectiveness of a fall awareness and education program in an acute care setting. Staff development educators working in acute care settings may find the strategies useful in addressing the issue of falls in their own institutions.

Nurses' job satisfaction and patient falls

PURPOSE

The growing concern about the low job satisfaction among nurses and the achievement of positive patient outcomes are critical healthcare issues. The purpose of this descriptive correlational study was to determine the relationship between nurses' job satisfaction and patient fall rate on adult medical and surgical units.

METHODS

Secondary data from a nurses' job satisfaction survey at a large not-for-profit acute care hospital on the East coast was used. The National Database of Nursing Quality Indicators-Adapted Index of Work Satisfaction (NDNQI-AIWS) was used to measure nurses' job satisfaction. The sample included 161 nurses from 12 adult acute medical and surgical units. The study used retrospective data collected by the Department of Nursing on patient fall rate. Pearson's correlation coefficient was used to determine the relationship between nurse job satisfaction and patient fall rate. In addition, exploratory descriptive analysis was conducted by type of unit (i.e., medical or surgical).

RESULTS AND CONCLUSION

No significant relationship was found between overall nurses' job satisfaction and patient fall rate. MD-RN interactions (r = .65) and decision-making (r = .57) were the job satisfaction subscales that showed a significant positive correlation with patient fall rate (p < .05). Recommendations for future research are provided.

Patient falls: acute care nurses' experiences

AIM

To describe the findings from a qualitative study exploring acute care nurses' experiences with patient falls.

BACKGROUND

Patient falls continue to be a problem in acute care settings for nurses at the point of care. Despite the growing body of knowledge related to risk factors and interventions for fall prevention, minimal attention has been given to nurses' perspectives of patient falls.

DESIGN

A qualitative descriptive design was used.

METHOD

Focus group discussions were conducted with nurses working on a cross-section of inpatient acute care settings. Audio-taped sessions were transcribed and analysed thematically.

RESULTS

Nurses described their experience of falls as 'knowing the patient as safe', an ongoing affirmation that the patient was free from harm. In this focused, narrowly defined and highly specific knowing, nurses employed the key strategies of assessment, monitoring and communicating. Variable conditions influenced whether these strategies were effective in giving nurses the knowledge they needed to keep the patient safe. When strategies failed to provide nurses with knowledge of their patients as safe and patients fell, this created considerable stress for nurses and prompted them to use a range of coping strategies.

CONCLUSION

Knowing the patient as safe has the potential to resolve the tension between patient safety and independence. The critical, often taken for granted, activities used by nurses in this knowing must be expanded to include the meaning falls have for patients and attend to factors beyond nurses control such as environmental redesign and staffing.

RELEVANCE TO CLINICAL PRACTICE

Nurses play an important role in fall prevention through knowing the patient as safe but must be supported through the use of a multi-faceted approach extending from the individual nurse to the institutional level.