Mcvey L, Alvarado N, Zaman H, Healey F, Todd C, Issa B, Woodcock D, Dowding D, Hardiker NR, Lynch A, Davison E, Frost T, Abdulkader J, Randell R. Interactions that support older inpatients with cognitive impairments to engage with falls prevention in hospitals: An ethnographic study.
J Clin Nurs 2024;
33:1884-1895. [PMID:
38240045 DOI:
10.1111/jocn.17006]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 12/13/2023] [Accepted: 01/07/2024] [Indexed: 02/22/2024]
Abstract
AIMS
To explore the nature of interactions that enable older inpatients with cognitive impairments to engage with hospital staff on falls prevention.
DESIGN
Ethnographic study.
METHODS
Ethnographic observations on orthopaedic and older person wards in English hospitals (251.25 h) and semi-structured qualitative interviews with 50 staff, 28 patients and three carers. Findings were analysed using a framework approach.
RESULTS
Interactions were often informal and personalised. Staff qualities that supported engagement in falls prevention included the ability to empathise and negotiate, taking patient perspectives into account. Although registered nurses had limited time for this, families/carers and other staff, including engagement workers, did so and passed information to nurses.
CONCLUSIONS
Some older inpatients with cognitive impairments engaged with staff on falls prevention. Engagement enabled them to express their needs and collaborate, to an extent, on falls prevention activities. To support this, we recommend wider adoption in hospitals of engagement workers and developing the relational skills that underpin engagement in training programmes for patient-facing staff.
IMPLICATIONS FOR PROFESSION AND PATIENT CARE
Interactions that support cognitively impaired inpatients to engage in falls prevention can involve not only nurses, but also families/carers and non-nursing staff, with potential to reduce pressures on busy nurses and improve patient safety.
REPORTING METHOD
The paper adheres to EQUATOR guidelines, Standards for Reporting Qualitative Research.
PATIENT OR PUBLIC CONTRIBUTION
Patient/public contributors were involved in study design, evaluation and data analysis. They co-authored this manuscript.
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