Article Text

Download PDFPDF

‘It promoted a positive culture around falls prevention’: staff response to a patient education programme—a qualitative evaluation
  1. Anne-Marie Hill1,
  2. Nicholas Waldron2,3,
  3. Jacqueline Francis-Coad4,5,
  4. Terry Haines6,7,
  5. Christopher Etherton-Beer8,9,
  6. Leon Flicker8,9,
  7. Katharine Ingram10,
  8. Steven M McPhail11,12
  1. 1School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
  2. 2Department of Rehabilitation and Aged Care, Armadale Kelmscott Memorial Hospital, Perth, Western Australia, Australia
  3. 3Health Strategy and Networks, Strategic System, Policy and Planning, Department of Health, Government of Western Australia, Perth, Western Australia, Australia
  4. 4School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
  5. 5Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
  6. 6Physiotherapy Department, Monash University, Melbourne, Victoria, Australia
  7. 7Allied Health Research Unit, Monash Health, Melbourne, Victoria, Australia
  8. 8WA Centre for Health and Ageing, Royal Perth Hospital Unit, School of Medicine and Pharmacology, Perth, Western Australia, Australia
  9. 9Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia
  10. 10Department of Rehabilitation and Aged Care, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
  11. 11Centre for Functioning and Health Research, Metro South Health, Brisbane, Queensland, Australia
  12. 12Institute of Health and Biomedical Innovation and School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
  1. Correspondence to Dr Anne-Marie Hill; anne-marie.hill{at}


Objectives The purpose of this study was to understand how staff responded to individualised patient falls prevention education delivered as part of a cluster randomised trial, including how they perceived the education contributed to falls prevention on their wards.

Design A qualitative explanatory study.

Methods 5 focus groups were conducted at participatory hospital sites. The purposive sample of clinical staff (including nurses, physiotherapists and quality improvement staff) worked on aged care rehabilitation wards when a cluster randomised trial evaluating a patient education programme was conducted. During the intervention period, an educator, who was a trained health professional and not a member of staff, provided individualised falls prevention education to patients with good levels of cognition (Mini-Mental State Examination >23/30). Clinical staff were provided with training to support the programme and their feedback was sought after the trial concluded, to understand how they perceived the programme impacted on falls prevention. Data were thematically analysed using NVivo qualitative data analysis software.

Results 5 focus groups were conducted at different hospitals (n=30 participants). Staff perceived that the education created a positive culture around falls prevention and further, facilitated teamwork, whereby patients and staff worked together to address falls prevention. The educator was perceived to be a valuable member of the team. Staff reported that they developed increased knowledge and awareness about creating a safe ward environment. Patients being proactive and empowered to engage in falls prevention strategies, such as ringing the bell for assistance, was viewed as supporting staff falls prevention efforts and motivating staff to change practice.

Conclusions Staff responded positively to patient falls prevention education being delivered on their wards. Providing individualised patient education to older patients with good levels of cognition can empower staff and patients to work as a team to address falls prevention on hospital rehabilitation wards.


This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

Statistics from


  • Contributors A-MH and NW contributed to study conception, design, site management, data collection and analyses. A-MH was responsible for principal manuscript drafting and editing. JF-C and SMM contributed to study conception, design, data management and analyses, manuscript drafting, appraisal and editing. KI, CE-B, NW and LF contributed to study conception, design and provided advice on data collection, management and analysis. TH contributed to study conception and design and intervention training for the education programme. All authors contributed to manuscript appraisal, revision and editing and read and approved the final manuscript.

  • Funding This work was supported by the Western Australian State Health Research Advisory Council and the Department of Health, Western Australia as part of the Research Translation Projects programme. This programme was established to encourage research and translation of outcomes into healthcare policy and practice. The key aim of the projects is to demonstrate improved cost-effectiveness and/or efficiencies to WA Health while maintaining or improving patient outcomes.

  • Competing interests None declared.

  • Ethics approval Sir Charles Gairdner Group HREC, North Metropolitan Health Service Western Australia.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.