McLennan Charlotte, Sherrington Catherine, Tilden Wendy, Jennings Matthew, Richards Bethan, Hill Anne-Marie, Fairbrother Greg, Ling Francis, Naganathan Vasi, Haynes Abby
School of Public Health, Faculty of Medicine and Health, The University of Sydney, A27 Fisher Rd, New South Wales, 2050, Australia.
Institute for Musculoskeletal Health, Sydney Local Health District, Level 10N, King George V Building, Royal Prince Alfred Hospital (C39), PO Box M179, Missenden Road, Sydney, New South Wales, 2050, New South Wales, Australia.
Age Ageing. 2024 Oct 1;53(10). doi: 10.1093/ageing/afae208.
Falls in hospital remain a common and costly patient safety issue internationally. There is evidence that falls in hospitals can be prevented by multifactorial programs and by education for patients and staff, but these are often not routinely or effectively implemented in practice. Perspectives of multiple key stakeholder groups could inform implementation of fall prevention strategies.
Clinicians of different disciplines, patients and their families were recruited from wards at two acute public hospitals. Semi-structured interviews and focus groups were conducted to gain a broad understanding of participants' perspectives about implementing fall prevention programs. Data were analysed using an inductive thematic approach.
Data from 50 participants revealed three key themes across the stakeholder groups shaping implementation of acute hospital fall prevention programs: (i) 'Fall prevention is a priority, but whose?' where participants agreed falls in hospital should be addressed but did not necessarily see themselves as responsible for this; (ii) 'Disempowered stakeholders' where participants expressed feeling frustrated and powerless with fall prevention in acute hospital settings; and (iii) 'Shared responsibility may be a solution' where participants were optimistic about the positive impact of collective action on effectively implementing fall prevention strategies.
Key stakeholder groups agree that hospital fall prevention is a priority, however, challenges related to role perception, competing priorities, workforce pressure and disempowerment mean fall prevention may often be neglected in practice. Improving shared responsibility for fall prevention implementation across disciplines, organisational levels and patients, family and staff may help overcome this.
在国际上，医院内跌倒仍然是一个常见且代价高昂的患者安全问题。有证据表明，通过多因素方案以及对患者和工作人员进行教育，可以预防医院内的跌倒，但在实际操作中，这些措施往往没有得到常规或有效的实施。多个关键利益相关者群体的观点可为跌倒预防策略的实施提供参考。
从两家急性公立医院的病房中招募了不同学科的临床医生、患者及其家属。进行了半结构化访谈和焦点小组讨论，以广泛了解参与者对实施跌倒预防方案的看法。使用归纳主题分析法对数据进行分析。
来自50名参与者的数据揭示了利益相关者群体中影响急性医院跌倒预防方案实施的三个关键主题：（i）“预防跌倒是优先事项，但由谁负责？”，参与者一致认为医院内的跌倒问题应得到解决，但不一定认为自己对此负责；（ii）“被剥夺权力的利益相关者”，参与者表示在急性医院环境中对跌倒预防感到沮丧和无力；（iii）“共同责任可能是一种解决方案”，参与者对集体行动对有效实施跌倒预防策略的积极影响持乐观态度。
关键利益相关者群体一致认为医院跌倒预防是一个优先事项，然而，与角色认知、相互竞争的优先事项、劳动力压力和权力剥夺相关的挑战意味着在实践中跌倒预防可能经常被忽视。加强跨学科、组织层面以及患者、家属和工作人员对跌倒预防实施的共同责任，可能有助于克服这一问题。
