Rebecca B Porter1, Laura Cullen, Michele Farrington, Grace Matthews, Sharon Tucker. 1. Rebecca B. Porter is a nursing practice leader and a clinical ethics resource nurse at the University of Iowa Hospitals and Clinics, Iowa City, where Laura Cullen is an evidence-based practice scientist, Michele Farrington is a clinical health care research associate, and Grace Matthews is a nursing practice leader. Sharon Tucker is the Grayce Sills Endowed Professor in psychiatric mental health nursing and director of the Translational Research Core at the Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare at the Ohio State University College of Nursing, Columbus; at the time of this writing, she was the director of nursing research, evidence-based practice and quality at the University of Iowa Hospitals and Clinics. Partial funding for this study was provided by the DAISY Foundation's J. Patrick Barnes Grant for Nursing Research and Evidence-Based Practice Projects. Contact author: Rebecca B. Porter, rebecca-b-porter@uiowa.edu. The authors and planners have disclosed no other potential conflicts of interest, financial or otherwise.
Abstract
: Purpose: This study aimed to address the knowledge gap between implementing and sustaining evidence-based fall prevention practices for hospitalized patients by exploring perspectives of the interprofessional health care team. DESIGN: A qualitative design was used to capture insights from clinicians across disciplines in a large midwestern academic medical center. METHODS: Four homogenous semistructured focus groups and three individual interviews involving a total of 20 clinicians were conducted between October 2013 and March 2014. Audio-recorded data were transcribed and analyzed using inductive qualitative analysis. FINDINGS: Two primary themes emerged from participants regarding the sustainability of an evidence-based fall prevention program: communication patterns within the interprofessional health care team and influences of hospital organizational practices and elements. Several subthemes also emerged. Participants gave nursing staff primary responsibility for fall risk assessment and prevention. CONCLUSIONS: Individual professional perceptions and practices, as well as organizational characteristics, affect the sustainability of evidence-based fall prevention practices. While all team members recognized patient falls as a significant quality and safety issue, most believed that direct care nurses hold primary responsibility for leading fall prevention efforts. The data support the importance of effective interprofessional team communication and organizational practices in sustaining an evidence-based fall prevention program across inpatient units. Furthermore, the data call into question the wisdom in labeling quality indicators as "nursing sensitive"; the evidence indicates that a team approach is best.
: Purpose: This study aimed to address the knowledge gap between implementing and sustaining evidence-based fall prevention practices for hospitalized patients by exploring perspectives of the interprofessional health care team. DESIGN: A qualitative design was used to capture insights from clinicians across disciplines in a large midwestern academic medical center. METHODS: Four homogenous semistructured focus groups and three individual interviews involving a total of 20 clinicians were conducted between October 2013 and March 2014. Audio-recorded data were transcribed and analyzed using inductive qualitative analysis. FINDINGS: Two primary themes emerged from participants regarding the sustainability of an evidence-based fall prevention program: communication patterns within the interprofessional health care team and influences of hospital organizational practices and elements. Several subthemes also emerged. Participants gave nursing staff primary responsibility for fall risk assessment and prevention. CONCLUSIONS: Individual professional perceptions and practices, as well as organizational characteristics, affect the sustainability of evidence-based fall prevention practices. While all team members recognized patient falls as a significant quality and safety issue, most believed that direct care nurses hold primary responsibility for leading fall prevention efforts. The data support the importance of effective interprofessional team communication and organizational practices in sustaining an evidence-based fall prevention program across inpatient units. Furthermore, the data call into question the wisdom in labeling quality indicators as "nursing sensitive"; the evidence indicates that a team approach is best.
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