title: A qualitative understanding of patient falls in inpatient mental health units.
abstract: BACKGROUND
  Falls are the leading cause of injury-related deaths among people age 65 and older, and fractures are the major category of serious injuries produced by falls.
  
  
  OBJECTIVE
  Determine market segment-specific recommendations for "selling" falls prevention in acute inpatient psychiatry.
  
  
  METHODS
  Descriptive using focus groups.
  
  
  METHODS
  One inpatient unit at a Veterans' hospital in the Southeastern United States and one national conference of psychiatric and mental health nurses.
  
  
  METHODS
  A convenience sample of 22 registered nurses and advanced practice nurses, one physical therapist and two physicians participated in one of six focus groups.
  
  
  METHODS
  None.
  
  
  METHODS
  Focus groups were conducted by expert facilitators using a semistructured interview guide. Focus groups were recorded and transcribed. Content analysis was used to organize findings.
  
  
  RESULTS
  Findings were grouped into fall risk assessment, clinical fall risk precautions, programmatic fall prevention, and "selling" fall prevention in psychiatry. Participants focused on falls prevention instead of fall injury prevention, were committed to reducing risk, and were receptive to learning how to improve safety. Participants recognized unique features of their patients and care settings that defined risk, and were highly motivated to work with other disciplines to keep patients safe.
  
  
  CONCLUSIONS
  Selling fall injury prevention to staff in psychiatric settings is similar to selling fall injury prevention to staff in other health care settings. Appealing to the larger construct of patient safety will motivate staff in psychiatric settings to implement best practices and customize these to account for unique population needs characteristics.
authors.affiliation: Gail Powell-Cope, PhD, ARNP, FAAN, VISN 8 Patient Safety Center of Inquiry, James A. Haley Veterans' Hospital, Tampa, FL, USA Gail.Powell-Cope@va.gov.
authors.forename: Gail
authors.initials: G
authors.lastname: Powell-Cope
authors.affiliation: Patricia Quigley, PhD, ARNP, CRRN, FAAN, FAANP, VISN 8 Patient Safety Center of Inquiry, James A. Haley Veterans' Hospital, Tampa, FL, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Quigley
authors.affiliation: Karen Besterman-Dahan, PhD, VISN 8 Patient Safety Center of Inquiry, James A. Haley Veterans' Hospital, Tampa, FL, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Besterman-Dahan
authors.affiliation: Maureen Smith, ARNP, James A. Haley Veterans' Hospital, Tampa, FL, USA.
authors.forename: Maureen
authors.initials: M
authors.lastname: Smith
authors.affiliation: Jonathan Stewart, MD, James A. Haley Veterans' Hospital, Tampa, FL, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Stewart
authors.affiliation: Christine Melillo, RN, MPH, James A. Haley Veterans' Hospital, Tampa, FL, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Melillo
authors.affiliation: Jolie Haun, PhD, VISN 8 Patient Safety Center of Inquiry, James A. Haley Veterans' Hospital, Tampa, FL, USA.
authors.forename: Jolie
authors.initials: J
authors.lastname: Haun
authors.affiliation: Yvonne Friedman, MA, OTR/L, CCRC, VISN 8 Patient Safety Center of Inquiry, James A. Haley Veterans' Hospital, Tampa, FL, USA.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Friedman
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D001294:Attitude to Health; D005260:Female; D017144:Focus Groups; D006778:Hospitals, Psychiatric; D006787:Hospitals, Veterans; D006801:Humans; D007297:Inpatients; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D009726:Nurses; D011568:Psychiatric Nursing; D018570:Risk Assessment
keywords: Pateint safety; evidence-based practice; treatment assessment & planning