Technology Supported Improvement, Management and Prevention of Accidental Falls in Hospitals

The student will observe fall prevention systems in practice in 2 different hospitals considering how fall prevention technology influences staff behaviour and patients safety in the context of accidental falls in hospital. Accidental falls in hospital are rare but can be life changing for those that suffer them as they are often frail patients who are already vulnerable. Current research shows little improvement with any interventions tested which leaves patient facing clinicians with few resources to assist in the prevention of falls. The investigator believes this is because the measure of accidental falls in hospital is not sensitive enough to calibrate for the different contexts in which patients fall. The student would posit that it is the context that is most influential and addressing the context may lead to improved measures so progress can be made in finding solutions.

The multi-centre study will involve up to 2 wards on each of the 2 Trust sites. The study wards will be randomly selected from a group of wards that have indicated they are happy to be considered as potential research wards. An ethnographic case study with contextual enquiry design will be used to allow a contextual analysis of fall prevention in practice and consider how staff decisions and behaviour contribute to this. Hierarchical task analysis (HTA) will be utilised to inform this and to identify differences between 'work as imagined' compared to 'work as done' . The study will use observations of the staff in clinical practice using their current system of fall prevention measures assisted by their existing technology and will illustrate outcomes with specific and transparent definitions. Calculations of falls occurring measured with local live data will compare with current standard measurements (Falls/1000 occupied bed days) as calculated with central occupancy data. The ward team, patients and relatives attending the wards will have an opportunity to complete a questionnaire about the use of fall prevention technology advertised in the ward environment on fliers and posters as permitted by policy. Recommendations for future technology design, research and use of technology in fall prevention will be provided on conclusion of the study.