A High Fall Risk Patient Perspective-Reducing Safety Challenges in an Acute Care Hospital.

Abstract

Aims: This study examined patient perspectives of the factors that contributed to their falls in a medical ward and how patient understanding of the implemented fall prevention strategies influenced their perceptions of their fall risk.

Design: An exploratory sequential mixed methods design.

Methods: Quantitative data were obtained from the RiskMan fall database and auditing of the Patient-Centred Care Plan to identify patients who experienced a fall on the ward. From this cohort, seven inpatients were interviewed using a structured interview questionnaire to explore their perceptions of why they fell. Other complexities of fall management in the ward were discussed, including the assessment and identification of high fall risk patients and the effectiveness of patient education.

Results: Five contributing factors were seen to have led to inpatient falls in the medical ward: (1) there seems to be little, if any, patient engagement with the advice in the fall prevention brochure distributed on admission; (2) insufficient patient awareness of the various fall prevention strategies; (3) inadequate bathroom supervision provided by nurses; (4) patient call bells not answered promptly, which encouraged patients engaging in risk-taking behaviour and (5) a breakdown in communication between nursing staff and patients. The study identified several factors that should be included in fall administrative data, such as the duration of call-bell response, the quality of nurse-patient communication and the determinants influencing patient response to fall prevention strategies. The study findings offer valuable insights to enhance the efficacy and implementation of fall prevention strategies to improve patient outcomes.

Patient contribution: Patients who had experienced a fall during their current hospital admission were interviewed. For each patient, the interview was a communication medium to explore the factors surrounding the occurrence of their fall and their knowledge of their fall risk.