Lysette Hakvoort1, Jeroen Dikken2, Maaike van der Wel3, Christel Derks4, Marieke Schuurmans5. 1. Máxima MC, De Run 4600, 5504 DB, Veldhoven, The Netherlands. lysette.hakvoort@mmc.nl. 2. De Haagse Hogeschool, Faculteit Gezondheid, Voeding & Sport, Johanna Westerdijkplein 75, 2521 EN, The Hague, The Netherlands. 3. Sint Franciscus Gasthuis en Vlietland, Kleiweg 500, 3004 BA, Rotterdam, The Netherlands. 4. Elisabeth Tweesteden Ziekenhuis, Dr. Deelenlaan 5, 5042 AD, Tilburg, The Netherlands. 5. Onderwijscentrum, UMC Utrecht, Heijmans van den Berghgebouw, 3508 GA, Utrecht, The Netherlands.
Abstract
BACKGROUND: The need for effective continuing education is especially high in in-hospital geriatric care, as older patients have a higher risk of complications, such as falls. It is important that nurses are able to prevent them. However, it remains unknown which interventions change the behavior of nurses. Therefore, the aim of this study is to identify intervention options to change the behavior of hospital nurses regarding fall prevention among older hospitalized patients. METHODS: This study used a mixed method design. The Behavior Change Wheel (BCW) was used to identify intervention functions and policy categories to change the behavior of nurses regarding fall prevention. This study followed the eight steps of the BCW and two methods of data collection were used: five focus groups and three Delphi rounds. The focus groups were held with hospital nurses (n = 26). Geriatric experts (n = 11), managers (n = 13) and educators (n = 13) were included in the Delphi rounds. All data were collected within ten tertiary teaching hospitals in the Netherlands. All participants were included based on predefined in- and exclusion criteria and availability. RESULTS: In Geriatric experts' opinions interventions targeting behavior change of nurses regarding fall prevention should aim at 'after-care', 'estimating fall risk' and 'providing information'. However, in nurses' opinions it should target; 'providing information', 'fall prevention' and 'multifactorial fall risk assessment'. Nurses experience a diversity of limitations relating to capability, opportunity and motivation to prevent fall incidents among older patients. Based on these limitations educational experts identified three intervention functions: Incentivisation, modelling and enablement. Managers selected the following policy categories; communication/marketing, regulation and environmental/social planning. CONCLUSIONS: The results of this study show there is a discrepancy in opinions of nurses, geriatric experts, managers and educators. Further insight in the role and collaboration of managers, educators and nurses is necessary for the development of education programs strengthening change at the workplace that enable excellence in nursing practice.
BACKGROUND: The need for effective continuing education is especially high in in-hospital geriatric care, as older patients have a higher risk of complications, such as falls. It is important that nurses are able to prevent them. However, it remains unknown which interventions change the behavior of nurses. Therefore, the aim of this study is to identify intervention options to change the behavior of hospital nurses regarding fall prevention among older hospitalized patients. METHODS: This study used a mixed method design. The Behavior Change Wheel (BCW) was used to identify intervention functions and policy categories to change the behavior of nurses regarding fall prevention. This study followed the eight steps of the BCW and two methods of data collection were used: five focus groups and three Delphi rounds. The focus groups were held with hospital nurses (n = 26). Geriatric experts (n = 11), managers (n = 13) and educators (n = 13) were included in the Delphi rounds. All data were collected within ten tertiary teaching hospitals in the Netherlands. All participants were included based on predefined in- and exclusion criteria and availability. RESULTS: In Geriatric experts' opinions interventions targeting behavior change of nurses regarding fall prevention should aim at 'after-care', 'estimating fall risk' and 'providing information'. However, in nurses' opinions it should target; 'providing information', 'fall prevention' and 'multifactorial fall risk assessment'. Nurses experience a diversity of limitations relating to capability, opportunity and motivation to prevent fall incidents among older patients. Based on these limitations educational experts identified three intervention functions: Incentivisation, modelling and enablement. Managers selected the following policy categories; communication/marketing, regulation and environmental/social planning. CONCLUSIONS: The results of this study show there is a discrepancy in opinions of nurses, geriatric experts, managers and educators. Further insight in the role and collaboration of managers, educators and nurses is necessary for the development of education programs strengthening change at the workplace that enable excellence in nursing practice.
Authors: Andrea C Tricco; Sonia M Thomas; Areti Angeliki Veroniki; Jemila S Hamid; Elise Cogo; Lisa Strifler; Paul A Khan; Reid Robson; Kathryn M Sibley; Heather MacDonald; John J Riva; Kednapa Thavorn; Charlotte Wilson; Jayna Holroyd-Leduc; Gillian D Kerr; Fabio Feldman; Sumit R Majumdar; Susan B Jaglal; Wing Hui; Sharon E Straus Journal: JAMA Date: 2017-11-07 Impact factor: 56.272
Authors: Patricia C Dykes; Zoe Burns; Jason Adelman; James Benneyan; Michael Bogaisky; Eileen Carter; Awatef Ergai; Mary Ellen Lindros; Stuart R Lipsitz; Maureen Scanlan; Shimon Shaykevich; David Westfall Bates Journal: JAMA Netw Open Date: 2020-11-02