Barriers and facilitators for sustainable fall prevention in a Chinese tertiary hospital: perspectives from nurses and managers

To investigate the facilitators and barriers influencing the implementation of a sustainability program for preventing falls and reducing injury from falls among hospitalized patients, using the Consolidated Framework for Implementation Research (CFIR).

The sample consisted of 21 nurse managers and key nursing staff from nine high-fall-risk pilot wards at a tertiary hospital in Beijing, China. Under the structural guidance of the CFIR, we collected data through semi-structured interviews with all participants. By conducting a qualitative descriptive analysis of this data, we identified key determinants influencing the implementation of fall prevention measures.

The study identified 23 implementation determinants, comprising 9 barriers, 2 neutral factors, and 12 facilitators, spanning all five domains and 19 of the 39 constructs within the CFIR framework. This study identified three key facilitators: the program's combination of scientific rigor and practical applicability, the presence of a supportive climate for evidence-based change, and strong institutional leadership backing. Conversely, several key barriers were identified, including insufficient nurse knowledge regarding fall risk screening and multifactorial assessment, challenges in determining rescreening timing, inadequate information systems, a shortage of nurses with evidence-based skills and practical experience, among others.

Multiple barriers and facilitators critically influence the implementation of the inpatient program for preventing falls and reducing injury from falls, and these factors are decisive for its successful execution. The findings establish a foundation for the development of effective implementation strategies to facilitate the integration of evidence into clinical practice, thereby improving fall management and reducing fall-related injuries.