Hospital falls prevention with patient education: a scoping review

Abstract

Background: Hospital falls remain a frequent and debilitating problem worldwide. Most hospital falls prevention strategies have targeted clinician education, environmental modifications, assistive devices, hospital systems and medication reviews. The role that patients can play in preventing falls whilst in hospital has received less attention. This critical review scopes patient falls education interventions for hospitals. The quality of the educational designs under-pinning patient falls education programmes was also evaluated. The outcomes of patient-centred falls prevention programs were considered for a range of hospital settings and diagnoses. Methods: The Arksey and O'Malley (2005) framework for scoping reviews was adapted using Joanna Briggs Institute and PRISMA-ScR guidelines. Eight databases, including grey literature, were searched from January 2008 until February 2020. Two reviewers independently screened the articles and data were extracted and summarised thematically. The quality of falls prevention education programs for patients was also appraised using a modified quality metric tool. Results: Forty-three articles were included in the final analysis. The interventions included: (i) direct face-to-face patient education about falls risks and mitigation; (ii) educational tools; (iii) patient-focussed consumer materials such as pamphlets, brochures and handouts; and (iv) hospital systems, policies and procedures to assist patients to prevent falls. The included studies assessed falls or education related outcomes before and after patient falls prevention education. Few studies reported incorporating education design principles or educational theories. When reported, most educational programs were of low to moderate quality from an educational design perspective. Conclusions: There is emerging evidence that hospital falls prevention interventions that incorporate patient education can reduce falls and associated injuries such as bruising, lacerations or fractures. The design, mode of delivery and quality of educational design influence outcomes. Well-designed education programs can improve knowledge and self-perception of risk, empowering patients to reduce their risk of falling whilst in hospital.

Patient Perspectives on Hospital Falls Prevention Education

“…The methods used for hospital falls education varied considerably for the participants in our focus groups. Consistent with the scoping review by Heng et al ( 4 ) the interventions included face-to-face advice from nurses and other health professionals, posters, pamphlets, brochures, bookmarks, occupational therapist led falls prevention groups, and educational videos for patients. The participants in our trial also reported variability of timing, delivery and follow up of patient information and education, which aligned with the findings of Lee et al ( 38 ).…”

“…The focus groups were conducted at the hospitals in which the participants were inpatients. The facilitator (SCS) guided the discussion with a list of interview questions that were derived from a scoping review ( 4 ) and from expert opinions from members of the study team ( Table 1 ). All sessions were audio-recorded and transcribed verbatim by an independent transcription service.…”

“…Patient education is often part of a multifactorial approach to falls prevention ( 1 – 3 ). Patients are educated about different falls prevention strategies including using the call bell to seek help, wearing safe footwear, using assistive devices such as walking frames when prescribed, avoiding multi-tasking and waiting for assistance when mobilizing ( 1 , 4 ). The published research shows that patient education can be effective in reducing falls-related outcomes, whether as part of a multifactorial program or as a single intervention ( 1 – 3 , 5 , 6 ).…”

“…The published research shows that patient education can be effective in reducing falls-related outcomes, whether as part of a multifactorial program or as a single intervention ( 1 – 3 , 5 , 6 ). A recent scoping review recommended that patient education programs should be designed based on educational principles and health behavior change models ( 4 ).…”

Education interventions for health professionals on falls prevention in health care settings: a 10-year scoping review

“…Falls can also incur substantial costs to hospitals and healthcare providers, insurers and individuals [6][7][8][9][10][11]. Despite extensive research on interventions designed to reduce the incidence of falls in hospitals, the quality of evidence is comparatively low, and the effects on falls risk in hospitals remains unclear [12,13].…”