2025 Article 6
Fall Risk Perceptions: A Study of Hospitalized Patients With Hematologic Malignancies
December 2018 • Volume 22, number 6, pages E159 - E165 • DOI: 10.1188/18.CJON.E159-E165
Background: Inpatient falls cause harm, increased length of stay, and high costs. Patients with hematologic malignancies have a unique set of fall risk factors, and studies indicate that patients lack accurate perception of fall risk.
Objectives: This study describes patient perceptions of fall risk in people with hematologic malignancies and compares patient and nurse perceptions of fall risk.
Methods: This mixed-methods study used descriptive statistical and narrative analyses. A convenience sample of patients was interviewed about perception of fall risk. Descriptive analysis of patient data and analysis around correlation between patient and nurse assessment of fall risk were completed. 
Findings: Themes emerged about participants’ prior experience with falls and perceptions of fall education. Participants who reported feeling weak prior to hospitalization perceived being at high fall risk, consistent with nurse assessment. Several patients reported feeling at low risk. Data showed discrepancies in patients’ perceptions of nursing education.
Discussion Starting Points:
Please choose two for your response:
How does this research article compare to our practice, policy and or procedure?
What are the advantages and disadvantages to the proposed recommendations in the article?
What are the advantages and disadvantages of implementing the article recommendations on your unit and/or hospital?
Was the correct method used? Why or why not?
How does this research article compare to our practice, policy and or procedure?
ReplyDelete- This research article somewhat speaks to our unit policy regarding fall risk patients whether or not they have a cancer diagnosis/history. Our policy lists a Fall Bundle that includes implementations that reduce the risk of falls for high risk individuals (even more so with bleeding precautions).
What are the advantages and disadvantages to the proposed recommendations in the article?
- and advantage of these recommendations would be to assess how the patient views their fall risk. Having them participate in a survey like the one in the article allows them to be an active participant of their treatment team. Another advantage of the survey results would allow nursing staff to then continue with Fall bundle policy or further educate the patient on how they scored. Some disadvantages of the survey would be if patients do not participate/answer the survey or if their mental status is impaired. Nonetheless, it would always be beneficial for a Fall Bundle to be established for every patient who is identified as a Fall risk. By doing this, we increase patient safety.
Your response makes a great connection between the article and our current fall prevention policy. I agree that while our Fall Bundle effectively addresses physical risk factors especially with added precautions for patients on bleeding protocols, the article introduces an important dimension by focusing on patient perception. Including patients in assessing their own fall risk through a simple survey could enhance engagement and help tailor education more effectively. You also make a good point about potential barriers, such as cognitive impairment or non-participation, which could limit the usefulness of the survey in some cases. Still, reinforcing the Fall Bundle for all at-risk patients remains a strong foundation for patient safety, and integrating perception based tools could be a valuable enhancement.
DeleteWhat are the advantages and disadvantages to the proposed recommendations in the article?
ReplyDeleteImplementing the recommendations from the study on patient and nurse perceptions of fall risk in individuals with hematologic malignancies offers several advantages and disadvantages. One key benefit is the potential for improved fall prevention through personalized patient education, which can help the gap between patient and nurse assessments of risk. This tailored approach encourages patient engagement, increases awareness, and may lead to a reduction in inpatient falls, ultimately improving patient outcomes and decreasing hospital costs. Additionally, it promotes interdisciplinary communication and supports a culture of safety. However, there are challenges to implementation, including increased demands on nursing staff time and potential variability in how education is delivered.
What are the advantages and disadvantages of implementing the article recommendations on your unit and/or hospital?
On our unit, implementing the article’s recommendations could lead to significantly improved patient outcomes, as many patients often feel physically capable despite being physiologically compromised. By aligning patients’ perceptions with clinical assessments, we may reduce fall-related adverse events, which would positively impact hospital safety metrics. This approach helps patient centered care, supporting accreditation standards and improving patient satisfaction. However, implementation in a high acuity setting presents challenges, especially where time and staffing are limited. There may be resistance from staff who believe current fall prevention protocols are sufficient, and accurately measuring the effectiveness of perception-based education on fall rates could be difficult.
What are the advantages and disadvantages of implementing the article recs on your unit and/or hospital?
ReplyDeleteThe advantage to implementing patients’ self-perception of fall risk would be to help alert the RN to potential high fall risk patients. A disadvantage would be that this tool is not always reliable. Especially on our unit, where so many of our patients are confused and not A/Ox4, the patient may give us an inaccurate assessment.
Was the correct method used? Why or why not?
The method used in this study was a mixed-methods study. This means it used numerical data and narrative analyses. The narrative analysis focuses on interpreting core narratives from the study groups personal stories rather than numbers. I believe this was the correct method to use since they main issue the article looked at was the patients’ own perception of their fall risk which is very subjective and cannot just be capture by numbers.
Article #6
ReplyDeleteWhat are the advantages and disadvantages to the proposed recommendations in the article?
An advantage to this article’s self assessment would be that the nursing staff would have an idea on where the patient might be in a fall risk scale. The nursing staff can prepare a fall risk bundle ahead of time to ensure patient safety. A disadvantage to this would be the honesty of a patient’s self assessment. A patient’s uncertainty or lack of orientation can cause them to make themselves a low fall risk when in reality they might need to be a med-high fall risk.
How does this research article compare to our practice, policy and or procedure?
Our hospital policy for a high risk fall patient includes the fall bundle for almost anybody on our unit who has a history of falls, on chemo, or is on pain medication. The majority of our patients in our unit have some type of cancer or hematologic disease which pose a higher fall risk than other units. This article described the common fall threats we endure throughout our unit.