Older Adults' Perceptions of Their Fall Risk and Prevention Strategies After Transitioning from Hospital to Home.

Falls are common adverse events following hospital discharge. However, prevention programs are not tailored for older patients transitioning home. To inform development of transitional fall prevention programs, nine older adults designated as being at risk of falls during hospitalization who were recently discharged home were asked about their perceptions of fall risk and prevention, as well as their knowledge and opinion of materials from the Centers for Disease Control and Prevention Stopping Elderly Accidents, Deaths & Injuries Initiative. Using the constant comparative method, five themes were identified: Sedentary Behaviors and Limited Functioning; Prioritization of Social Involvement; Low Perceived Fall Risk and Attribution of Risk to External Factors; Avoidance and Caution as Fall Prevention; and Limited Falls Prevention Information During Transition from Hospital to Home. Limited awareness of and engagement in effective fall prevention may heighten recently discharged older adults' risks for falls. Prevention programs tailored to the post-discharge period may engage patients in fall prevention, promote well-being and independence, and link hospital and community efforts. [Journal of Gerontological Nursing, 45(1), 23-30.].

Perspectives of 30 English Patients on Call Light Technology, Eloquence Revisited.

Call light technology is important because it serves as a direct link for patients to get their healthcare needs fulfilled by their healthcare providers. As primary users of call light technology, patient perspectives are important and warranted. Despite this fact, there is a lack of published literature regarding patient perspectives and call light technology. The present study examined a technologically advanced call light system (Eloquence) by incorporating 30 patient participants' perspectives regarding its usefulness, effectiveness, and appropriateness gathered from individual interviews. Using qualitative descriptive research methods, five major themes and multiple minor themes emerged from the data.

Registered Nurse and Nursing Assistant Perceptions of Limited English-Proficient Patient-Clinician Communication.

In this article, the authors discuss implications for nurse administrators from a recent qualitative study regarding nursing personnel perceptions of limited English proficient (LEP) patient-clinician communication. Few studies have examined nursing personnel's use and perceptions of communication resources when caring for LEP patients.

Conduits to care: call lights and patients' perceptions of communication.

BACKGROUND: Call light systems remain the primary means of hospitalized patients to initiate communication with their health care providers. Although there is vast amounts of literature discussing patient communication with their health care providers, few studies have explored patients' perceptions concerning call light use and communication. The specific aim of this study was to solicit patients' perceptions regarding their call light use and communication with nursing staff. METHODS: Patients invited to this study met the following inclusion criteria: proficient in English, been hospitalized for at least 24 hours, aged ≥21 years, and able to communicate verbally (eg, not intubated). Thirty participants provided written informed consent, were enrolled in the study, and completed interviews. RESULTS: Using qualitative descriptive methods, five major themes emerged from patients' perceptions (namely; establishing connectivity, participant safety concerns, no separation: health care and the call light device, issues with the current call light, and participants' perceptions of "nurse work"). Multiple minor themes supported these major themes. Data analysis utilized the constant comparative methods of Glaser and Strauss. DISCUSSION: Findings from this study extend the knowledge of patients' understanding of not only why inconsistencies occur between the call light and their nurses, but also why the call light is more than merely a device to initiate communication; rather, it is a direct conduit to their health care and its delivery.

The effect of a translating research into practice intervention to promote use of evidence-based fall prevention interventions in hospitalized adults: A prospective pre-post implementation study in the U.S.

BACKGROUND: Falls are a major public health problem internationally. Many hospitals have implemented fall risk assessment tools, but few have implemented interventions to mitigate patient-specific fall risks. Little research has been done to examine the effect of implementing evidence-based fall prevention interventions to mitigate patient-specific fall risk factors in hospitalized adults. OBJECTIVES: To evaluate the impact of implementing, in 3 U.S. hospitals, evidence-based fall prevention interventions targeted to patient-specific fall risk factors (Targeted Risk Factor Fall Prevention Bundle). Fall rates, fall injury rates, types of fall injuries and adoption of the Targeted Risk Factor Fall Prevention Bundle were compared prior to and following implementation. DESIGN: A prospective pre-post implementation cohort design. SETTING: Thirteen adult medical-surgical units from three community hospitals in the Midwest region of the U.S. PARTICIPANTS: Nurses who were employed at least 20hours/week, provided direct patient care, and licensed as an RN (n=157 pre; 140 post); and medical records of patients 21years of age or older, who received care on the study unit for more than 24hours during the designated data collection period (n=390 pre and post). METHODS: A multi-faceted Translating Research Into Practice Intervention was used to implement the Targeted Risk Factor Fall Prevention Bundle composed of evidence-based fall prevention interventions designed to mitigate patient-specific fall risks. Dependent variables (fall rates, fall injury rates, fall injury type, use of Targeted Risk Factor Fall Prevention Bundle) were collected at baseline, and following completion of the 15month implementation phase. Nurse questionnaires included the Stage of Adoption Scale, and the Use of Research Findings in Practice Scale to measure adoption of evidence-based fall prevention practices. A Medical Record Abstract Form was used to abstract data about use of targeted risk-specific fall prevention interventions. Number of falls, and number and types of fall injuries were collected for each study unit for 3months pre- and post-implementation. Data were analyzed using multivariate analysis. RESULTS: Fall rates declined 22% (p=0.09). Types of fall injuries changed from major and moderate to minor injuries. Fall injury rates did not decline. Use of fall prevention interventions improved significantly (p<0.001) for mobility, toileting, cognition, and risk reduction for injury, but did not change for those targeting medications. CONCLUSIONS: Using the Translating Research Into Practice intervention promoted use of many evidence-based fall prevention interventions to mitigate patient-specific fall risk factors in hospitalized adults.

Patient perceptions and experiences with falls during hospitalization and after discharge.

AIMS: The aim of this study was to describe hospitalized older adults' (> 60years) perceptions about (1) their fall risks while hospitalized; (2) fall prevention interventions received while hospitalized; and (3) fall prevention discharge instructions. BACKGROUND: Little is known about hospitalized older adults' perceptions regarding fall prevention interventions received during hospitalization and fall prevention discharge instructions. METHODS: This is a prospective, exploratory study using qualitative methods. RESULTS: This paper reports qualitative findings of patients' perspectives on fall prevention interventions during hospitalization and at discharge. Eight major themes supported by multiple minor themes emerged: overall perceptions of falling; overall perceptions of fall prevention interventions while hospitalized; "telling" fall prevention; "doing" fall prevention; effectiveness of fall prevention strategies; personal fall prevention strategies; fall-related discharge instructions; and most effective fall-related discharge instructions. CONCLUSIONS: Findings suggest healthcare providers need to more fully engage patients and families in understanding fall prevention interventions and factors contributing to falls during hospitalization and at discharge.

Spanish-Speaking Limited English Proficiency Patients and Call Light Use.

INTRODUCTION: Despite a continuous increase of the limited English proficiency (LEP) population in the United States, disparities in the quality of care received in health care systems persist. METHOD: This qualitative study explores the perceptions of hospitalized LEP patients on their call light use, as well as their perceptions of a prototype of a new multilingual call light system, Eloquence™. Individual interviews were conducted with 10 Spanish-speaking patient participants. RESULTS: Using a constant comparative method, the following themes emerged: (1) reasons for call light use, (2) challenges with communication, (3) patients' adaptation to language barriers, (4) perceived staff responses to call light, and (5) responses to the Eloquence™ demonstration. CONCLUSION: Data from this study shed light on the patient care experience of LEP patients and can help guide clinicians and administrators in providing culturally and linguistically competent care.

Nurses' Perceptions of Implementing Fall Prevention Interventions to Mitigate Patient-Specific Fall Risk Factors.

Evidence-based (EB) fall prevention interventions to mitigate patient-specific fall risk factors are readily available but not routinely used in practice. Few studies have examined nurses' perceptions about both the use of these EB interventions and implementation strategies designed to promote their adoption. This article reports qualitative findings of nurses' perceptions about use of EB fall prevention interventions to mitigate patient-specific fall risks, and implementation strategies to promote use of these interventions. The findings revealed five major themes: before-study fall prevention practices, use of EB fall prevention interventions tailored to patient-specific fall risk factors, beneficial implementation strategies, overall impact on approach to fall prevention, and challenges These findings are useful to guide nurses' engagement and use of EB fall prevention practices tailored to patient-specific fall risk factors.

Perspectives of Nurses on Patients With Limited English Proficiency and Their Call Light Use.

Patients use call light systems to initiate communication with their health care team. Little is known how this process is affected when language barriers exist between an English-speaking nurse and a patient with limited English proficiency (LEP). The aims of this study are to describe (a) the perceptions of nurses regarding their communication with patients with LEP, (b) how call lights affect their communication with patients with LEP, and (c) the perceptions of nurses on the impact of advancement in call light technology on patients with LEP. Using focus groups, nurses were asked about their interactions with patients with LEP. The following themes emerged: barriers to communication, formal tools for communication, gestures and charades, reliance on family, creating a better call light system, and acceptability of Eloquence™. This results show that call lights affect the interaction of nurses with patients with LEP and complex issues arise in the subsequent communication that is initiated by the call light.

Perspectives of Nurses and Patients on Call Light Technology.

Call lights are prevalent in inpatient healthcare facilities across the nation. While call light use directly influences the delivery of nursing care, there remain significant gaps both in research and technology that can affect the quality of care and patient satisfaction. This study examines nurse and patient perceptions of the use of a new call communication solution, Eloquence, in the acute care inpatient setting. Eighteen patients were recruited for the study and participated in individual semistructured interviews during their hospital stay. Eighteen nurses were recruited and participated in focus groups for this study. Qualitative descriptive methods were used to analyze the data. Results revealed themes of usability, improved communication, and suggestions for improvement to the alpha prototype design. After a demonstration of the use and capability of Eloquence, nurse and patient participants found Eloquence as a welcomed advancement in nurse call technology that has the potential to improve workflow and patient outcomes. In addition, the participants also proposed ideas on how to further develop the technology to improve its use.