BACKGROUND Falls in hospital remain a common and costly patient safety issue internationally. There is evidence that falls in hospitals can be prevented by multifactorial programs and by education for patients and staff, but these are often not routinely or effectively implemented in practice. Perspectives of multiple key stakeholder groups could inform implementation of fall prevention strategies. METHODS Clinicians of different disciplines, patients and their families were recruited from wards at two acute public hospitals. Semi-structured interviews and focus groups were conducted to gain a broad understanding of participants' perspectives about implementing fall prevention programs. Data were analysed using an inductive thematic approach. RESULTS Data from 50 participants revealed three key themes across the stakeholder groups shaping implementation of acute hospital fall prevention programs: (i) 'Fall prevention is a priority, but whose?' where participants agreed falls in hospital should be addressed but did not necessarily see themselves as responsible for this; (ii) 'Disempowered stakeholders' where participants expressed feeling frustrated and powerless with fall prevention in acute hospital settings; and (iii) 'Shared responsibility may be a solution' where participants were optimistic about the positive impact of collective action on effectively implementing fall prevention strategies. CONCLUSION Key stakeholder groups agree that hospital fall prevention is a priority, however, challenges related to role perception, competing priorities, workforce pressure and disempowerment mean fall prevention may often be neglected in practice. Improving shared responsibility for fall prevention implementation across disciplines, organisational levels and patients, family and staff may help overcome this.

中文翻译：

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在急性医院环境中实施跌倒预防计划时跨多个利益相关者群体的考虑因素：一项定性研究。


背景 跌倒在国际上仍然是一个常见且代价高昂的患者安全问题。有证据表明，在医院跌倒可以通过多因素计划以及对患者和工作人员的教育来预防，但这些在实践中往往没有常规或有效地实施。多个关键利益相关者群体的观点可以为跌倒预防策略的实施提供信息。方法 从两家急症公立医院的病房招募不同学科的临床医生、患者及其家属。进行了半结构化访谈和焦点小组，以广泛了解参与者对实施跌倒预防计划的看法。使用归纳主题方法分析数据。结果 来自 50 名参与者的数据揭示了影响急性医院跌倒预防计划实施的利益相关者群体的三个关键主题：（i） “预防跌倒是一个优先事项，但谁？”参与者同意应该解决医院跌倒问题，但不一定认为自己对此负责;（ii） “被剥夺权力的利益相关者”，参与者表示对急性医院环境中的跌倒预防感到沮丧和无能为力;（iii） “责任共担可能是一种解决方案”，参与者对集体行动对有效实施跌倒预防策略的积极影响持乐观态度。结论 主要利益相关者群体同意预防医院跌倒是一项优先事项，但是，与角色感知、竞争优先事项、劳动力压力和剥夺权力相关的挑战意味着跌倒预防在实践中可能经常被忽视。 加强跨学科、组织层面以及患者、家庭和工作人员对预防跌倒实施的共同责任可能有助于克服这一问题。