Behavior of nurses regarding fall prevention: How it is and how it should be.

Abstract

Background/Aim: In-hospital falls among older patients are serious adverse events, which lead to a reduced quality of life. Therefore, preventing them is very important. This study targets two aims. The first aim is to specify the target behavior and the second aim is to identify the current behavior and perspectives of Dutch hospital nurses regarding fall prevention among older hospitalized patients. The target behavior relates to the behavior that is most promising to change. The COM-B (Capability, Opportunity, Motivation-Behavior) model was used to identify the behavior of nurses. Methods: The study used a generic qualitative approach. For specification of target behavior, a two-round Delphi with experts in Geriatrics was used. Experts answered open and closed questions by e-mail. The method of Lynn was used to analyze the Delphi data. Then, for identification of current behavior and perspectives, focus groups with hospital nurses were executed. Thematic analyses was used to analyze the focus groups. Participants of the Delphi and the focus groups came out of ten teaching hospitals in the Netherlands. Results: The Delphi included 13 experts and in their opinion ‘after-care’, ‘estimating fall risk’ and ‘providing information’ are the most relevant target behaviors. The five focus groups included 26 nurses. Nurses experience a lack of knowledge and important preconditions such as mobilization tools and find it difficult to include patients’ perspectives in their fall prevention care. Implications: Future research should use the results of this study to develop a multicomponent fall prevention program. Furthermore, nurses and managers need to use the results of this study to create awareness and provide for preconditions to prevent in-hospital falls and improve quality of patient care.