Predictors of Implementation of Evidence-Based Fall Management Among Nursing Staff in Geriatric Hospitals

Purpose: Falls are one of the most frequent critical health problems for elderly in long term care settings. Injuries are a significant cause of morbidity and mortality. Implementing preventive management to lower the incidence of falls would go a long way to improve the quality of care in long term care settings. Nursing staff play an active and essential role in falls prevention. Evidence-based practice is a key recommendation to improve patient care outcomes. Although the Institute of Medicine has set the goal that 90 percent of clinical decisions will be evidence-based by 2020, low rate of nursing staff deliver evidence-based practice. The purpose of this study was to identify predictors that influence nursing staff’s implementation of evidence-based fall management in geriatric hospitals. Methods: This study consisted of 505 nursing staff from long term care hospitals in Korea. The survey was designed to investigate nursing staff’s knowledge, belief, organizational culture, competency and implementation of evidence based practice regarding fall management. Results: The results of stepwise regression analysis indicated that the nursing staff’ knowledge, belief, organizational culture and competency for evidence-based practice explain 54.9% of evidence based fall management performed in geriatric hospitals. Among these factors, the significant predictors were organizational culture of evidence based fall management (β=.37, p<.001) belief of evidence based fall management(β=.27, p<.001), knowledge of evidence based fall management(β=.19, p<.001) and competency of evidence based fall management(β=.18, p<.001). Belief of evidence based fall management and organizational culture of evidence based fall management were found to be the strong predictors of evidence based fall management implementation among nursing staff in geriatric hospitals. Conclusion: The results of this study suggest that there is a need to develop a systematic program to enhance individual nursing staff’s belief of evidence based practice at individual level and to foster innovative organizational culture toward evidence based practice at organizational level.