Effect of nurses' resilience on fall prevention in acute-care hospital: A mixed-methods qualitative study

To understand the distinctive experience and use of strategies of high- and low-resilience nurses aiming to prevent patient falls.

Falls among inpatients continue to threaten patient safety in the hospital. Nurses may have the greatest impact on reducing patient falls. However, little is known about whether nurses' personal resilience is associated with patients' fall prevention strategies.

The study employed a descriptive mixed-methods design combining quantitative (questionnaires) and qualitative (observations, semi-structured interviews).

One major theme, from maintaining routine to taking control over patients' falls, and three subthemes, scepticism, anticipation and proactivity representing feelings, cognitions and behaviours characterizing high- versus low-resilience nurses emerged from the findings.

Three successive resilience strategies, starting with hunches that elicit scepticism, through cognitions of anticipation the worst-case scenario that could happen to the patient, and concluding with proactive behaviours characterize resilient nurses, helping them to prevent patients' falls.

Nursing managers seeking to decrease the devastating rate of patient falls can encourage nurses to have an inquiring mind (scepticism), be alert for the unexpected (anticipation) and take control over the environment (proactive behaviours) to make things happen instead of watching them happen.