Abstract
We aimed to gain insight into the barriers and facilitators to fall risk screening of older adults visiting the hospital as experienced by patients and healthcare professionals, and to examine the differences between chronic- and acute-care patients. We invited patients (≥70 years) attending the nephrology and emergency department to participate in the screening. Patients and their healthcare professionals were asked to complete a self-administered questionnaire based on the “Barriers and Facilitators Assessment Instrument”. Differences in barriers and facilitators between acute- and chronic-care patients were examined with chi-square tests. A total of 216 patients were screened, and 103 completed the questionnaire. They considered many factors as facilitators, and none as barriers. Acute-care patients were more positive than chronic-care patients about healthcare worker characteristics, such as knowledge and skills. After screening, patients were more open to receiving advice regarding fall prevention. The 36 healthcare professionals considered program characteristics to be facilitators and mainly factors regarding healthcare worker characteristics as barriers to implementation. For patients, the outpatient setting seemed to be a good place to be screened for fall risk. Healthcare professionals also suggested that program characteristics could enhance implementation. However, healthcare professionals’ mindsets and the changing of routines are barriers that have to be addressed first.
Highlights
Worldwide, falls and fall-related injuries in older adults are a major public health problem [1].They can cause a decline in the physical and social functioning of older adults [2] and have a huge economic burden on society [3]
Most patients were positive about the non-invasive screening and willing to participate, which resulted in patients being more open to receiving fall-prevention advice
From that point of view, fall risk screening in these outpatient settings could be the first step to preventing falls among older adults by improving their fall risk awareness during their hospital visits
Summary
Falls and fall-related injuries in older adults are a major public health problem [1]. They can cause a decline in the physical and social functioning of older adults [2] and have a huge economic burden on society [3]. Of all older adults aged 65 years and older, one third experience a fall each year [4,5,6]. According to the European Public Health Association [5], at least 3.8 million older people visit the emergency department (ED) due to a fall-related injury each year. 1.4 million need further treatment and are admitted to the hospital.
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