Citation

Singh H, Craven BC, Flett HM, Kerry C, Jaglal SB, Silver MP, Musselman KE. BMC Health Serv. Res. 2019; 19(1): e391.

Affiliation

Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada. Kristin.Musselman@uhn.ca.

Copyright

(Copyright © 2019, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s12913-019-4233-8

PMID

31208427

Abstract

BACKGROUND: 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.

METHODS: 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.

RESULTS: 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).

CONCLUSIONS: Fall prevention policies/procedures required by the hospitals were insufficient for clinical practice in SCI rehabilitation.

Language: en

Keywords

Administrators; Fall prevention; Health policy; Interpretive description; Rehabilitation hospital; Spinal cord injury