Purpose: The primary purpose of this original research study was to evaluate the effectiveness of a tailored, video-based educational intervention on adult inpatients’ engagement in fall prevention plans. The second purpose was to compare clinical and demographic correlates of outcomes in the experimental and control groups, which is the focus of this abstract.
Background/significance: Falls during hospitalization could be reduced if alert patients fully engaged in fall prevention plans. Education can influence engagement, yet research has not yet verified the effectiveness of specific educational strategies and the extent to which educational interventions are effective across demographic groups. This study tested the impact of theory-based video education, tailored to the age and gender of medical-surgical inpatients. Results for the study’s primary purpose, reported elsewhere, documented the effectiveness of the intervention in improving intention to engage in fall prevention activities (p < .018) and increasing awareness of consequences of falling (p < .001). This abstract reports on demographic and clinical variations in these perceptions, as well as differences in number of falls and number of high-risk behaviors for falls, such as ambulating without staff supervision.
Methods: The study was a randomized control trial with a pre-test/post-test two-group design. Participants were alert inpatients at a Midwestern teaching hospital, over 44 years of age and at-risk for falls. The intervention group (n = 60) viewed a four-minute video featuring scenarios of inpatients, matched to participants’ age range and gender, who did and did not engage in fall prevention plans. The control group (n = 64) received standard fall prevention education with no video component. All participants completed the Fall Perceptions Survey before and after the intervention or control condition. Other data were extracted from medical records.
Results: No participants fell after study enrollment. 25% of the total sample exhibited high-risk behaviors for falls, with an equal percentage of participants in the control and experimental groups demonstrating high-risk behaviors. The older the participant, the more high-risk behaviors were exhibited (p < .05). No associations were noted between high-risk behaviors and gender, admitting diagnoses, or number of co-morbidities. Participants of all ages and genders who had fallen in the months prior to admission were least likely to exhibit high-risk behaviors. Participants of all ages and genders receiving opioid therapies were more likely to exhibit high-risk behaviors. Regarding perceptual outcomes, no age or gender differences were noted in scores on the intention-to-engage scale. On the anticipated consequences of falling scale, older males scored significantly lower than younger males and all female participants.
Conclusions/implications for practice: The video-based intervention tailored to age and gender positively influenced perceptions of inpatients over the age of 44, both males and females but did not make a significant difference in high-risk behaviors for falls. Nurses can integrate low-burden, video-based education when tailoring prevention plans for at-risk patients, with particular attention to inpatients receiving opioids and older inpatients, especially males.
Evidence-based references 1. Arkkukangas, M., Eriksson, H. G., & Dension, E. (2021). Risk factors for fall-related injuries among communitydwelling men and women over 70 years of age, based on social cognitive theory: results from a population study. European Journal of Physiotherapy, 23(4), 221-226 2. Dahodwala, M., Geransar, R., Babion, J., de Grood, J., & Sargious, P. (2018). The impact of the use of video-based educational interventions on patient outcomes in hospital settings: a scoping review. Patient Education and Counseling, 101(12), 2116-2124. 3. Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., ... & Bates, D. W. (2020). Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial. JAMA network open, 3(11), e2025889-e2025889. 4. Tucker, S., Sheikholeslami, D., Farrington, M., Picone, D., Johnson, J., Matthews, G., ... & Cullen, L. (2019). Patient, nurse, and organizational factors that influence evidence‐based fall prevention for hospitalized oncology patients: An exploratory study. Worldviews on Evidence‐Based Nursing, 16(2), 111-120. 5. Zhao, Y. L., Bott, M., He, J., Kim, H., Park, S. H., & Dunton, N. (2019). Evidence on fall and injurious fall prevention interventions in acute care hospitals. JONA: The Journal of Nursing Administration, 49(2), 86-92.
MS, APRN, ACNS-BC, MEDSURG-BC,
Medical-Surgical Clinical Nurse Specialist,
IU Health Ball Memorial Hospital