Fall Prevention Decision Making of Acute Care Registered Nurses

J Nurs Adm. 2020 Sep;50(9):442-448. doi: 10.1097/NNA.0000000000000914.

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.

MeSH terms

  • Accidental Falls / prevention & control*
  • Adult
  • Attitude of Health Personnel*
  • Clinical Competence
  • Decision Making*
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Nurse Administrators
  • Nurses / psychology*