Using a systems perspective to understand hospital falls among patients with dementia.

Abstract

Background Falls are a frequent event among older adults with dementia during their hospital stay. This qualitative study explores the factors contributing to falls in this population using a systems perspective. Methods Semi-structured interviews were conducted with 32 carers of patients with dementia and 20 hospital staff who worked on medical wards. Interview transcripts were analysed thematically using a systems framework. Results The themes generated from this falls research were factors related to the: patient (e.g. their physical health), carer (e.g. their ability to re-call a patient's past medical history), staff (e.g. teamwork), hospital policies (e.g. transfer of patients between wards), the hospital environment (e.g. lack of observation side rooms for infectious patients who are at risk of falls on some wards) and the use of hospital equipment (e.g. walking aid). Conclusion We recommend that future hospital falls intervention programmes need to be supported by a credible systems approach aiming to improve patient outcomes in relation to falls prevention.