title: The nurse as bricoleur in falls prevention: learning from a case study of the implementation of fall prevention best practices.
abstract: BACKGROUND
  Falls prevention in "real-life" clinical practice is a complex undertaking. Nurses play an active and essential role in falls prevention.
  
  
  OBJECTIVE
  This discussion paper presents a picture of the nurse as a bricoleur in falls prevention, requiring knowledge in many areas and the ability to perform multiple diverse tasks.
  
  
  METHODS
  Building on a qualitative case study with nurses at various levels in three acute care facilities, this paper posits that the concept of nurse as bricoleur has the potential to broaden our understanding of the complexity of falls prevention.
  
  
  RESULTS
  The nurse as bricoleur within the Promoting Action Research in Health Services framework as the provider of person- or patient-centered evidence-based care is conceptualized. Within this framework, the nurse uses his or her professional knowledge or clinical experience while considering research, local data, and information, and the patient's experience and preferences to provide this care, the bricolage. Each of these areas is discussed as well as the impact on the nurse when a fall does occur.
  
  
  CONCLUSIONS
  Recognizing this complexity of the nurses' world has important implications for both service delivery and education, including preparation of students, and the implementation of new organizational initiatives and supports for nurses when falls do occur despite the best efforts of all involved.
authors.affiliation: BPSO Co-ordinator, St. Joseph's Healthcare Hamilton, and Assistant Clinical Professor, McMaster University School of Nursing, Hamilton, ON, Canada.
authors.forename: Helen
authors.initials: H
authors.lastname: Kirkpatrick
authors.forename: Sheryl
authors.initials: S
authors.lastname: Boblin
authors.forename: Sandra
authors.initials: S
authors.lastname: Ireland
authors.forename: Kim
authors.initials: K
authors.lastname: Robertson
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D002983:Clinical Competence; D055318:Evidence-Based Nursing / Q000458:organization & administration*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D024802:Nurse's Role; D061214:Patient Safety; D018802:Patient-Centered Care / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D017751:Safety Management / Q000458:organization & administration*
keywords: PARiHS framework; bricoleur; case study; evidence-based practice; fall prevention; nursing; patient falls