Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork City, Ireland.
Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
PLoS One. 2024 Sep 9;19(9):e0310139. doi: 10.1371/journal.pone.0310139. eCollection 2024.
Falls are a serious health problem in long-term care facilities (LTCFs), affecting more than 50% of residents. A key role of LTCF staff is to assess fall risks and implement fall prevention activities. Understanding the barriers and facilitators is key to successful implementation.
This descriptive qualitative study involving four LTCF facilities (varied provider types and sizes) in southwest Ireland. We recruited a convenience sample of 17 LTCF staff, who participated in semi-structured online 1:1 interviews (n = 7) or small group interviews (n = 10). The data were analysed using Braun and Clarke's reflective thematic analysis.
The participants included two directors of nursing, three therapists, one ward manager, one general practitioner, five nurses and five healthcare assistants. Six main themes were identified, reflecting factors that influenced fall prevention: a need for sufficient staff and appropriate skill mix; fall policy, documentation and leadership; equipment and safe environments; person-centred care; staff knowledge, skills and awareness in falls prevention; and staff communication and collaborative working. A wide range of approaches that supported LTCF staff to overcome barriers were identified, including audits and feedback, falls champions, fall prevention leaders, daily communication (e.g., safety pauses) and staff collaboration. Formal multidisciplinary meetings and identification systems to highlight residents at high risk of falling were not considered helpful. Staff suggested that education should be briefer, ongoing and practice-based ("brief but often") to promote ownership and responsibility.
LTCF staff identified several approaches to prevent falls in LTCFs as part of usual care, rather than lengthy, formal meetings and training. The potential role of families in fall prevention was under-appreciated and should be investigated further.
跌倒在长期护理机构（LTCF）中是一个严重的健康问题，影响了超过 50%的居民。LTCF 工作人员的一个关键角色是评估跌倒风险并实施跌倒预防活动。了解障碍和促进因素是成功实施的关键。
本描述性定性研究涉及爱尔兰西南部的四家 LTCF 设施（不同的提供者类型和规模）。我们招募了一个方便的 17 名 LTCF 工作人员样本，他们参加了半结构化的在线 1:1 访谈（n = 7）或小组访谈（n = 10）。使用 Braun 和 Clarke 的反思主题分析对数据进行了分析。
参与者包括两名护理主任、三名治疗师、一名病房经理、一名全科医生、五名护士和五名医疗保健助理。确定了六个主要主题，反映了影响跌倒预防的因素：需要足够的员工和适当的技能组合；跌倒政策、文件和领导力；设备和安全环境；以患者为中心的护理；工作人员在跌倒预防方面的知识、技能和意识；以及工作人员的沟通和协作。确定了多种方法来支持 LTCF 工作人员克服障碍，包括审计和反馈、跌倒冠军、跌倒预防领导者、日常沟通（例如，安全停顿）和工作人员协作。正式的多学科会议和识别系统来突出有高跌倒风险的居民被认为没有帮助。工作人员建议，教育应该更简短、持续和基于实践（“简短但经常”），以促进所有权和责任感。
LTCF 工作人员确定了一些在 LTCF 中预防跌倒的方法，作为常规护理的一部分，而不是冗长的正式会议和培训。家庭在跌倒预防中的潜在作用被低估了，应该进一步调查。
