2.1 Facilitating interprofessional teamwork and collaboration.More than a third of participants identified the value of an interprofessional approach to facilitating falls prevention education. Nurses and allied health professionals advised that interprofessional teamwork facilitated consistent and frequent patient education. They expressed a view that, with effective communication, health professionals could address falls risk factors in a more united and holistic manner and have a collective approach to consistent falls education. Three allied health professionals advised regularly consulting nurses and other health professionals about the patient’s functional status to form a holistic view of their needs. Two nurses reported that they worked with the multidisciplinary team to identify falls prevention strategies for complex patients. This collaborative practice approach promoted collective responsibility and patient-centred care to ensure that individual patient needs were addressed by the team (Box 4).

1.1 Sub-optimal systems for falls education for patients and health professionals.Many participants (n = 14) identified barriers at an organisational level, citing inconsistencies in clinical practice. These included variations in the content and design of falls education programs, differences in documenting falls and falls risk, and disparities in falls prevention education and communication between hospital sites, professions, and patients (Box 1). A third of participants viewed communication about falls prevention as being inconsistent between hospital sites. One example was differing organisational policies where patients were given non-slip socks to prevent falls in an acute setting yet encouraged to wear sturdy footwear to prevent falls in a sub-acute setting. One clinician highlighted that, due to hospital policy, falls prevention strategies were often broadly implemented using standard methods instead of being individualised to the needs of patients (Box 1).

The study was approved by the La Trobe University Human Research Ethics Committee (HEC19373) and was registered in the Australian New Zealand Clinical Trials Registry (ACTRN12620000033943).

The data were analysed thematically to identify patterns and develop themes [32]. Following the transcription of audio-recordings, the audio files and transcribed documents were compared to ensure accuracy.

Once informed consent was obtained, focus groups were conducted at a convenient time for the stakeholders at each hospital site. The interview questions were developed with expert advice from members of the study team and after considering the analysis from a scoping review (Table 1) [9]. The interview aimed to obtain health professional views on the enablers and barriers to evidence-based patient falls education. Interviews were semi-structured with the interviewer using the list of questions as a guide. Each focus group interview was audio-recorded and transcribed verbatim by a third-party transcription service. To ensure anonymity, each participant was de-identified with a number used in all transcripts and questionnaires.

A purposive sampling methodology was used to recruit participants at one acute and two rehabilitation hospitals. The research team liaised with allied health managers and nurse unit managers for recruitment and the managers distributed participant information statements to potential participants. Participants were reassured that there was no compulsion for them to participate and declining to participate would not disadvantage them in any way.

Semi-structured focus groups with nursing and allied health professionals were conducted at three large Australian hospitals. To gain a deep understanding of health professional views and experiences of hospital falls prevention education, an explorative and descriptive qualitative design was selected [32, 33]. Thematic analysis was used to identify patterns and ideas across participant data [32, 34]. A descriptive qualitative approach to data analysis allowed major themes to be captured [17]. A focus group design was chosen as it allowed for new insights that can arise from participant interactions [35, 36].

The aims of this study were to: (i) explore health professional views of the enablers and barriers to delivering evidence-based patient falls prevention education programs in hospitals; and (ii) understand health professional perceptions of appropriate educational delivery for hospitalised patients.

Since nursing and allied health professionals are the main providers of falls prevention education in hospitals, it is imperative for them to deliver patient education effectively, with consideration to evidence-based approaches.

When this was done effectively, patients and health professionals were empowered to prevent falls [2, 8, 22]. Patient falls education was shown to improve patient knowledge and awareness of falls mitigation strategies, as well as health professional motivation for delivering education [2, 22].

Health professionals have a key role in mitigating falls in hospitals [1, 2]. This includes delivering multi-factorial interventions that include patient education, clinician training, rehabilitation, exercises, environmental modifications, and optimal hospital falls systems and policies [3–6].

In hospitals, patient falls prevention education is frequently delivered by nurses and allied health professionals. Hospital falls rates remain high globally, despite the many systems and approaches that attempt to mitigate falling. The aim of this study was to investigate health professional views on the enablers and barriers to providing patient falls education in hospitals. Four focus groups with 23 nursing and allied health professionals were conducted at 3 hospitals. Three researchers independently coded the data and findings were analysed thematically with a descriptive qualitative approach to identify and develop themes according to barriers and enablers. Barriers included (i) limited interprofessional communication about patient falls; (ii) sub-optimal systems for falls education for patients and health professionals, and (iii) perceived patient-related barriers to falls education. Enablers to providing patient falls education included: (i) implementing strategies to increase patient empowerment; (ii) ensuring that health professionals had access to effective modes of patient education; and (iii) facilitating interprofessional collaboration. Health professionals identified the need to overcome organisational, patient and clinician-related barriers to falls education. Fostering collective responsibility amongst health professionals for evidence-based falls prevention was also highlighted.