Weber Kathrin, Knueppel Lauener Susanne, Deschodt Mieke, Grossmann Florian, Schwendimann René
Department of Practice Development in Nursing, University Hospital Basel, Basel, Switzerland.
Department of Public Health & Primary Care, KU Leuven, Leuven, Belgium and Competence Center of Nursing, University Hospitals Leuven, Leuven, Belgium.
Int J Nurs Sci. 2024 Oct 5;11(5):513-520. doi: 10.1016/j.ijnss.2024.08.012. eCollection 2024 Nov.
Inpatient falls are a major patient safety issue in acute care hospitals. Multifactorial in-hospital fall prevention programs have shown reductions in falls and related risks. One common element of successful programs is active patient involvement. This study objective was to explore patients' and nurses' experiences with a structured intervention to foster patient involvement.
This study was conducted between September 2020 and April 2021 in a university hospital neurological ward. The studied intervention consisted of a falls information leaflet, and a structured nurse-patient conversation about fall risk-reduction activities. Nurses were trained to deliver the intervention and supported throughout the study. Nurses' and patients' experiences regarding personal involvement, satisfaction, and confidence were surveyed and analyzed quantitatively and qualitatively.
Fifty-six patients recruited by ward nurses received the intervention. After receiving the intervention, patients reported high levels of satisfaction with the in-hospital fall prevention conversation. Twenty-one nurses indicated that they would use the leaflet and communication aid. Twenty-one nurses commented on intervention facilitators and barriers. More specific facilitators included their shared perception that "handing out the leaflet to patients was not problematic" and that the leaflet was seen as "applicable in many patient situations." Their comments indicated two particularly prominent barriers to conducting the intervention in clinical practice: 1) "finding the time for the implementation in the daily clinical routine and workload" and 2) "environmental factors like a noisy and busy atmosphere on the ward."
This study provides insights into a patient involvement intervention featuring a structured nurse-patient discussion about fall risks. The accompanying information leaflet and communication guide require adaptations to facilitate sustainable implementation into the hospital's fall prevention program, but proved useful.
住院患者跌倒在急症医院中是一个重大的患者安全问题。多因素的院内跌倒预防项目已显示出跌倒及相关风险有所减少。成功项目的一个共同要素是患者的积极参与。本研究的目的是探讨患者和护士在一项促进患者参与的结构化干预措施中的体验。
本研究于2020年9月至2021年4月在一家大学医院的神经科病房进行。所研究的干预措施包括一份跌倒信息手册,以及一次关于降低跌倒风险活动的结构化护患对话。护士接受了实施该干预措施的培训,并在整个研究过程中得到支持。对护士和患者在个人参与度、满意度和信心方面的体验进行了调查,并进行了定量和定性分析。
病房护士招募的56名患者接受了该干预措施。接受干预后,患者对院内跌倒预防对话的满意度很高。21名护士表示他们会使用该手册和沟通辅助工具。21名护士对干预措施的促进因素和障碍发表了评论。更具体的促进因素包括他们共同的看法,即“向患者发放手册没有问题”,并且该手册被视为“适用于许多患者情况”。他们的评论指出了在临床实践中实施该干预措施的两个特别突出的障碍:1)“在日常临床工作和工作量中找到实施的时间”以及2)“病房嘈杂繁忙的环境因素”。
本研究为一项以结构化护患讨论跌倒风险为特色的患者参与干预措施提供了见解。随附的信息手册和沟通指南需要进行调整,以促进在医院跌倒预防项目中的可持续实施,但已证明是有用的。