Factors influencing fall prevention for patients with spinal cord injury from the perspectives of administrators in Canadian rehabilitation hospitals

• Published in: BMC health services research Vol. 19; no. 1; p. 391
• Main Authors: Singh, H, Craven, B C, Flett, H M, Kerry, C, Jaglal, S B, Silver, M P, Musselman, K E
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 17-06-2019; BioMed Central; BMC
• Subjects: Accidental falls; Administrators; Analysis; Care and treatment; Data collection; Education; Fall prevention; Falls; Health care; Health policy; Health risk assessment; Health services; Hospitals; Injury prevention; Interpretive description; Interviews; Management; Nursing; Older people; Organizations; Patient safety; Physical therapy; Prevention; Qualitative research; Rehabilitation; Rehabilitation centers; Rehabilitation hospital; Risk assessment; Software; Spinal cord injuries; Spinal cord injury; Canada; Administrators; Fall prevention; Health policy; Spinal cord injury; Interpretive description; Rehabilitation hospital
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-019-4233-8

Fall prevention is a priority in Canadian tertiary rehabilitation hospitals. We aimed to understand the perspectives of hospital administrators on the challenges experienced when implementing fall prevention policies/procedures for patients with spinal cord injury (SCI) in tertiary rehabilitation hospitals.
Semi-structured interviews were conducted with 10 administrators employed in six Canadian tertiary rehabilitation hospitals. Guided by an interpretive description framework, interviews were analyzed using a constant comparison approach.
Challenges with fall prevention experienced by administrators fell into the three categories: 1) fall prevention policy and procedural challenges (e.g. fall prevention policy not SCI-specific, expectation of zero falls, determining contributing factors, learning from falls, and overall effectiveness of the fall prevention policy), 2) clinician-related challenges (e.g. variable staff adherence with the organizations' fall prevention procedures, inconsistent delivery of fall prevention education, and integrating individualized fall risks to guide clinical practice), and 3) patient-related challenges (e.g. balancing risk vs independence and rehabilitation progress, responsibility for fall prevention, and non-preventable falls).
Fall prevention policies/procedures required by the hospitals were insufficient for clinical practice in SCI rehabilitation.