Elizabeth A Fehlberg1, Christa L Cook, Ragnhildur I Bjarnadottir, Anna M McDaniel, Ronald I Shorr, Robert J Lucero. 1. Author Affiliations: Health Services Researcher (Dr Fehlberg), Division of Research on Healthcare Value, Equity, and the Lifespan, RTI International, Research Triangle Park, North Carolina; Associate Professor (Dr Cook), College of Nursing, University of Central Florida, Orlando; Assistant Professor (Dr Bjarnadottir), Dean and Linda Harman Aiken Professor (Dr McDaniel), and University Term Professor and Associate Professor (Dr Lucero), College of Nursing, University of Florida, Gainesville; and Director (Dr Shorr), Geriatric Research Education and Clinical Centers (GRECC), Malcom Randall VAMC, Gainesville, Florida.
Abstract
OBJECTIVE: The aim of this study was to examine acute care registered nurses' (RNs') fall prevention decision-making. BACKGROUND: The RN decision-making process related to fall prevention needs to be investigated to ensure that hospital policies align with nursing workflow and support nursing judgment. METHODS: Qualitative semistructured interviews based on the Critical Decision Method were conducted with RNs about their planning and decision making during their last 12-hour shift worked. RESULTS: Data saturation was achieved with 12 RNs. Nine themes emerged related to the RN decision-making process and included hospital-level (eg, fear of discipline), unit-level (eg, value of bed alarm technology), and nurse-level (eg, professional judgment) factors that could influence fall prevention. CONCLUSIONS: Nursing administrators should consider a multilevel approach to fall prevention policies that includes promoting a practice environment that embraces self-reporting adverse events without fear of shame or being reprimanded, evaluating unit-level practice and technology acceptance and usability, and supporting autonomous nursing practice.
OBJECTIVE: The aim of this study was to examine acute care registered nurses' (RNs') fall prevention decision-making. BACKGROUND: The RN decision-making process related to fall prevention needs to be investigated to ensure that hospital policies align with nursing workflow and support nursing judgment. METHODS: Qualitative semistructured interviews based on the Critical Decision Method were conducted with RNs about their planning and decision making during their last 12-hour shift worked. RESULTS: Data saturation was achieved with 12 RNs. Nine themes emerged related to the RN decision-making process and included hospital-level (eg, fear of discipline), unit-level (eg, value of bed alarm technology), and nurse-level (eg, professional judgment) factors that could influence fall prevention. CONCLUSIONS: Nursing administrators should consider a multilevel approach to fall prevention policies that includes promoting a practice environment that embraces self-reporting adverse events without fear of shame or being reprimanded, evaluating unit-level practice and technology acceptance and usability, and supporting autonomous nursing practice.
Authors: Ronald I Shorr; A Michelle Chandler; Lorraine C Mion; Teresa M Waters; Minzhao Liu; Michael J Daniels; Lori A Kessler; Stephen T Miller Journal: Ann Intern Med Date: 2012-11-20 Impact factor: 25.391
Authors: Amanda Garcia; Ragnhildur Raga I Bjarnadottir; Gail M Keenan; Tamara G R Macieira Journal: J Nurs Care Qual Date: 2021-11-12 Impact factor: 1.728