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Mobilisation Alarm Use in Hospitals and Alignment With Person-Centred Practice: A Qualitative Study
Kelly Stephen1,2, Dai Pu1, Jennifer Weller-Newton3,4
1School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Australia.
Aim:
To explore why and how staff use alarms for falls prevention in hospital and their alignment to person-centred practice.
Design:
Qualitative interpretive design.
Methods:
One hundred focus groups and 25 interviews across 10 health services were completed between October 2022 and September 2024. Participants included nurses (n = 451), allied health (n = 82), and fall prevention managers (n = 18). The Framework Method guided initial data familiarisation and analysis and led to the Person-Centred Practice Framework being identified as a useful framework.
Results:
Themes generated: (1) Understaffed, under-resourced, under pressure, (2) Alarm impact on stress and workload, (3) Negotiating patient safety and patient preference, (4) Engaging family as a resource, (5) Sharing responsibility for alarms and falls prevention, and (6) Navigating ambiguity and fearing consequences.
Conclusion:
Staff feel compelled to use alarms despite problems associated with their use and challenges to person-centred practice. Drivers of alarm use were feeling under-resourced and fearing liability if patients fell. Staff want clearer organisational guidance in alarm use but also want the freedom to use their own clinical reasoning.
Impact:
Hospitals worldwide are working to identify effective strategies for preventing falls. However, research has yet to adequately explore the perspectives of frontline nurses and allied health staff regarding the use of mobilisation alarms-a critical gap when evaluating their impact and effectiveness. This study's six key themes provide insights into why alarms are so widely used despite the limited evidence supporting their effectiveness.
Reporting Method:
Consolidated Criteria for Reporting Qualitative Research.
Patient Or Public Contribution:
This study did not include patient or public involvement in its design, conduct, or reporting.
Trial And Protocol Registration:
Australian New Zealand Clinical Trials Registry ACTRN12621000823875.
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