Knowledge, attitude, and practice toward fall risk-increasing drugs among nurses: a cross-sectional survey

Fall risk-increasing drugs (FRIDs) are a main risk factor for falls and fall-related injuries, particularly among inpatients. Nurses play a critical role in reducing fall risks and managing FRIDs within healthcare settings. In this study, we aimed to assess nurses' knowledge, attitude, and practice (KAP) regarding FRIDs and identify the influencing factors.

Based on the KAP theoretical framework, we developed a structured questionnaire to evaluate FRID-related KAP among nurses. An online survey was conducted using this questionnaire across 31 hospitals in Guangdong Province, China, between December 2024 and February 2025. Statistical analyses were performed using IBM SPSS 26.0. Univariate analysis and ordinal logistic regression analysis with logit as the link function were used for identifying influencing factors. Spearman correlation analysis was used for assessing relationships among knowledge, attitude, and practice.

Of the 600 nurses invited to participate in this survey, 542 (90.3%) completed the valid questionnaires. The median scores of nurses' knowledge, attitude, and practice toward FRIDs were 56.0 [interquartile range (IQR): 47.0-67.0], 44.0 (IQR: 36.0-45.0) and 47.0 (IQR: 42.0-55.0), respectively. The training experience, department, and professional title were significant factors for nurses' knowledge. Attitude was positively influenced by the training experience and professional title. Practice was mainly influenced by the training experience. Nurses' knowledge was significantly associated with attitude (r = 0.476, p < 0.001) and practice (r = 0.551, p < 0.001), while their attitude was significantly associated with practice (r = 0.526, p < 0.001).

Nurses demonstrated a moderate level of knowledge, positive attitude, and appropriate practices toward FRIDs. Training experience emerged as a consistent positive influencing factor across all three domains. Therefore, enhancing FRID-related training programs, through improved content design and incentive mechanisms, might effectively strengthen nurses' KAP and contribute to better fall-prevention outcomes.