'They will tell me if there is a problem': limited discussion between health professionals, older adults and their caregivers on falls prevention during and after hospitalization

Abstract

The objectives of this study were to describe the sources of falls prevention information provided to older adults during and after hospitalization, identify and explore reasons why discussion about falls prevention may not take place. Six participant groups were interviewed using semi-structured interviews or focus groups: (i) older patients (n = 16); (ii) caregivers (n = 8); (iii) allied health and nursing professionals (n = 33); (iv) doctors from acute wards (n = 8); (v) doctors from subacute wards (n = 10) and (vi) general practitioners (n = 9). Participants were recruited from three Australian hospitals that provided acute and subacute in-patient services to the older adults. General practitioners were recruited from the community of Melbourne. Findings showed provision of falls prevention information was dependent on setting of the ward and which health professionals the older adult encountered during and after hospitalization. Medical practitioners were reactive in providing information, whereas older adults and their caregivers were passive in seeking falls prevention information. Several barriers in information provision and information seeking were identified. There is great potential to improve the consistency of falls prevention information provision to older adults during hospitalization and in preparation for discharge to assist with prevention of falls in this high risk period.

Investigating Community Perspectives on Falls Prevention Information Seeking and Delivery: Older Person Perceptions Regarding Preferences for Falls Prevention Education Using a World Cafe Approach

“…While there is conclusive evidence that interventions such as regular exercise can reduce falls (Gillespie LD et al, 2012) older people have been found to have low self-perceived risk of falls and low levels of knowledge about falls and falls prevention (Haines, Day, Hill, Clemson, & Finch, 2014;Lee, McDermott, Hoffmann, & Haines, 2013). Furthermore, older people have also been shown to have limited engagement in falls prevention activities Simek, McPhate, & Haines, 2012) (Dickinson et al, 2011;Yardley, Donovan-Hall, Francis, & Todd, 2007), We therefore decided to take a step back from evaluating older people's perceptions of falls programs and to re-engage the community in partnership to explore how they would prefer to seek and receive falls related information, also furthermore how they would like falls prevention education to be delivered.…”

Conceptual definitions of indicators for the nursing outcome "Knowledge: Fall Prevention"

“…The situations pointed out in the literature in which patients need to request personal assistance are those activities in which, due to the reduction of their abilities, they are no longer able to perform alone, such as getting out of bed and/or going to the bathroom (12,26) . Conceptual definition: the patient describes his or her knowledge about when to ask for help to perform activities that is not able to perform alone due to physical limitation.…”

“…Indicator (182809) Use of safe transfer procedure Cautions cited in studies related to safe transfer procedures include: getting up slowly, sitting for a moment before moving, using the assistive device to perform the transfer if necessary, ensuring that the wheels are locked and bed is in the low position (12,18,23) . Conceptual definition: the patient describes his or her knowledge of how to safely transfer between bed, chair and wheelchair.…”

“…The restraints of the patient with risk for fall involve: the exit of the bed and the walking without follow-up (12) . The title of this indicator was maintained according to the meaning of its nomenclature in the NOC: 5th edition.…”

“…In the context of falls prevention, NOC presents several results that can be used by the nurse to evaluate patients at risk for falls. Among them, the NO (1828) Knowledge: Fall Prevention was selected as an study object, since it has a link with educational interventions that have been increasingly emphasized to promote patient awareness of their risk and the need to prevent falls, stimulating change in habits and behaviors in order to avoid the event (12)(13) . Thus, the NO (1828) Knowledge: Prevention of falls, defined as an "extent of understanding conveyed about prevention of falls", may support the nurse in the assessment of patient knowledge and educational interventions implemented in the hospital setting.…”