Nurses' knowledge, self-efficacy, and workplace support in fall prevention: a cross-sectional study

Patient falls are a persistent safety issue in acute care settings, particularly in resource-limited healthcare environments. Nurses play a critical role in fall prevention, yet their effectiveness can be hindered by insufficient training, low self-efficacy, and lack of institutional support.

To examine the relationships between nurses' fall prevention knowledge, self-efficacy, and structural empowerment; and to assess how these factors collectively influence fall prevention outcomes in Jordanian hospitals.

A quantitative, cross-sectional study was conducted with 78 registered nurses from medical, surgical, and geriatric units. Validated instruments - the Fall Prevention Knowledge Test (FPKT), Self-Efficacy for Preventing Falls Scale (SEPFN) and Conditions of Work Effectiveness Questionnaire II (CWEQ-II) - were used for data collection. Descriptive statistics, Pearson correlation, and multiple regression analyses were performed using the Statistical Package for the Social Sciences (SPSS) (v25).

A significant positive correlation was found between fall prevention knowledge and self-efficacy (r = 0.294, p = 0.017). Structural empowerment did not moderate this relationship. A negative correlation was identified between self-efficacy and perceived institutional support (r = -0.249, p = 0.047). Units with higher average nurse self-efficacy had lower fall rates (2.1 vs 3.4 per 1000 patient days), though this difference was only marginally significant (p = 0.089).

Nurses' knowledge and self-efficacy are key to effective fall prevention. However, institutional support structures may not align with the needs of confident and experienced nurses. Targeted training, mentorship, and workload management are essential to improve patient outcomes. Policymakers should prioritise personalised support systems and standardised fall prevention protocols.