Purpose: The purpose of this research study was to examine the effect of a tailored, video-based fall prevention intervention on inpatients’ fall-related perceptions and intention to engage in fall prevention activities.
Background/significance: Falls are a common and costly cause of injury during hospitalization. Falls could be avoided if alert, oriented adult inpatients fully engaged in fall prevention plans. Education can influence patients’ engagement and perceptions related to fall prevention plans, yet research has not yet verified the effectiveness of customized educational strategies for fall prevention. Video-based fall prevention strategies tailored to patients’ demographic characteristics have not been tested on medical-surgical inpatients.
Methods: In this randomized control trial with a pre-test, post-test, two-group design, the intervention was a three-minute video, tailored to adults’ age and gender, with content based on the protection motivation theory and social cognitive theory. Videos featured enactments of real-life stories of inpatients who were at risk for falls and were making decisions about mobilizing with and without assistance. Pre- and post- intervention, participants completed the fall-related perceptions survey, which measured intention to engage in fall prevention plans, perceptions of confidence in mobilizing safely without nursing assistance, anticipated consequences of falling, likelihood/risk of falling, and fear of falling. Criteria for the random sample were: over 44 years of age, medically stable, alert and oriented, inpatient on a medical-surgical unit at the target Midwestern hospital, and at risk for falls. Power analysis called for 128 participants. Participants were randomly assigned to either the experimental group to receive video-based fall prevention intervention and standard fall prevention education or the control group, which received only standard fall prevention education.
Results: The majority of the sample (n = 130) was female (60%), with a mean age of 70.1 years. The most common diagnoses were infection, diabetes, and fractures. No baseline differences were noted between the intervention and control groups. Pre-intervention, over two-thirds of all participants were not afraid of falling, did not perceive they were likely to fall, and did not perceive they would be injured from falling during hospitalization. Post-intervention, participants who received the educational intervention reported increased fear of falling (p < .001), perceived likelihood of falling (p < .02), perceived risk of injury if they fell (p < .001), anticipation of deleterious consequences of falling (p < .03), and intention to engage in fall prevention plans (p < .006), compared to the control group. Males were significantly less likely to anticipate deleterious consequences if they fell and expressed less intention to engage in fall prevention activities (p < .001). No age-related differences were noted.
Conclusions/Implications: The video-based educational intervention was effective in elevating participants’ (a) awareness of fall risk, (b) possible deleterious outcomes of a fall, and (c) intention to engage in fall prevention activities. Nurses can assess patients’ perceptions related to falling and willingness to engage in personalized fall prevention plans. Nurse educators can consider the cost-effectiveness of preparing real-life video stories as a means of reducing falls among alert, oriented inpatients.
After completing this learning activity, the participant will assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.