Oncology Patients Perceptions of Fall Prevention for Sustainable Hospital Programs

Purpose:
This paper describes patients' perspectives of their fall risks and prevention strategies while hospitalized on 1of 4 academic medical center oncology units. These data are one part of a study examining factors that strengthen evidence-based fall prevention to improve fall rates below benchmarks.

Background/Significance:
Fall prevention is a patient safety priority in every institution. Yet 3% - 20% of hospitalized patients still fall. Hospital fall prevention programs must address patient risk factors (e.g., 45% of falls are related to toileting) and context. Limited evidence exists to specifically guide fall prevention strategies for oncology patients. Moreover, capturing patients' perceptions is important but largely missing to help guide practice recommendations and fall prevention programs.

Methods:
Human subjects' protection approval was obtained from the IRB. A convenience sample of 39 adult oncology patients who had been hospitalized for less than 3 days, were receiving inpatient cancer treatment, and communicated in English participated in a brief study interview. Following obtaining informed consent, patients were interviewed by a study member. Data collected include patient demographics, patient beliefs related to fall risk, fall prevention strategies, asking for assistance to prevent falls, talking with their healthcare team about fall risks, nurses routinely assessing risk, and use of equipment to prevent falls. Descriptive statistics were used to summarize interview findings.

Results:
Participants (n=39; mean age = 58.9) were 64% male, 64% married, 92% white, and 70% had completed some college. 36% reported a fall in the past five years, 18% with injury, yet 56% did not believe they were at risk of falling while in the hospital. 77% identified being at risk of injury if they fell. 74% rated adequate hearing and vision as very important, yet 36% rated assistance to the bathroom as not at all important. Most 62% felt daily nursing assessment (62%) and reporting a change in health (85%) was very important. Participants reported the most important thing they could do to prevent falling was to get help (30%), be careful (30%) and use fall-prevention equipment (13%).

Conclusions and Implications for Practice:
Participants did not see themselves as at-risk for falling, despite that 36% had a history of falling. 36% rated bathroom assistance as not important despite being a top contributor to inpatient falls. Patients' perceptions are important for planning and implementation of fall prevention programs.