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Fall risk prevention: The related factors of nurses practice at general local hospital in Indonesia
Lilis Suryania,
Corresponding author
lilis.suryanifa@gmail.com

Corresponding author.
, Agni Laili Perdanib, Regidor III Diosoc, Lee Siew Hoonc
a Department of Nursing Management, STIKes Kharisma Karawang-Indonesia 41315, Indonesia
b Department of Pediatric Nursing, STIKep PPNI Jawa Barat, Indonesia
c Faculty of Nursing, Lincoln University College, Malaysia
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Every hospital must perform standard for patient safety to prevent and decrease unnecessary incidents&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">1&#44;2</span></a> Through execute&#44; six standards is a way to improve the system and to reduce the risk of falling is one of the crucial part&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">2</span></a> An approach was developed because there was a significant number of falling cases that caused injury for hospitalised patients&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The reported incidence of patients falling in US hospitals ranged from 700&#44;000 to 1&#44;000&#44;000 every year&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">3</span></a> In Indonesia&#44; data showed that rates of falling patients included in the top three hospital medical incidents and ranked second after medicine error up to 34 cases or 14&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">4</span></a> By this data proved that this event is still very high and far from accreditation targets with or 0&#37; case&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The role of nurses as a service provider will give a massive effect to implement patient safety&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">6&#44;7</span></a> The previous study described that nurse practice have great contribution in this programme&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">8</span></a> Several factors influenced including nurse practice are predisposing factors&#44; enabling factors&#44; and driving factors&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">9</span></a> Moreover&#44; knowledge&#44; facilities&#44; supporting education and supervision are affected nurses to achieve the goal of prevention fall risk&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">10</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The result from a preliminary study conducted in the inpatient room of RSUD X in February 2018&#44; the results of interviews with nurses who have experienced 2 patients falling in the past year&#44; identified that 6 out of 10 nurses had poor knowledge related to preventing fall for patients&#46; Although four nurses had good knowledge but missed regarding documentation and assessment&#46; Negative attitude showed by nurses with indifferent and inaccurate to prevent fall risk related to inadequate facilities such as there is no handle in patients bathroom&#44; patients bed without bell and coloured signs&#46; One nurse said that family patient regularly plays with those signs&#59; therefore&#44; a nurse keeps in the storage room&#46; Education or training for healthcare professionals also still minimum about patient safety&#46; From the last one year&#44; two patients had been recorded fall and without injury in the bathroom in this hospital&#46; By description above this study aimed was to describe related factors of nurse practice in preventing fall risk in an inpatient ward at X General Local Hospital&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">A descriptive and analytical quantitative with a cross-sectional approach was used in this study&#46; This research conducted in one month from February to March 2018&#46; The total population of this study is 206 and inclusion criteria were all nurses work in the inpatient room at one of a general hospital in Indonesia&#46; By using simple random sampling&#44; a total of 95 nurses agreed to participate in this study&#46; An instrument used in this study is a structured self-report questionnaire to measure knowledge&#44; attitudes&#44; training and observational about behaviour form filled by the researcher&#46; The statistical model using a chi-square analysis&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Demographic characteristics</span><p id="par0030" class="elsevierStylePara elsevierViewall">This study described demographic characteristics including age&#44; gender and level of education&#46; Nurses participated in this study aged &#60;40 years&#44; with the proportion of 47 &#40;49&#46;4&#37;&#41; women and 48 &#40;50&#46;6&#37;&#41; men&#46; More than a half of nurses with the total of 59 &#40;62&#46;1&#37;&#41; respondents graduated from Diploma III of Nursing&#47;Midwifery&#44; and 36 &#40;37&#46;9&#37;&#41; from Bachelor of Nursing&#47;Diploma IV of Midwifery&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Nurses knowledge&#44; attitude&#44; training and practice towards the prevention of fall risk</span><p id="par0035" class="elsevierStylePara elsevierViewall">Based on the result from <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#44; more than half of nurses had poor knowledge &#40;54&#46;7&#37;&#41;&#44; negative attitude &#40;53&#46;7&#37;&#41; and poor practice&#40;56&#46;8&#37;&#41;&#46; Data described in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> showed that from 95 respondents with both poor knowledge and practice were29 respondents &#40;55&#46;8&#37;&#41;&#46; The total of respondents with good knowledge and practice was31 &#40;72&#46;1&#37;&#41;&#46; A statistically significant result obtained <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;012</span>&#59; therefore&#44; there was a relationship between knowledge and practice of nurses in preventing fall risk among patients&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Nurses with poor attitude as well as a practice were 30 &#40;58&#46;8&#37;&#41;&#44; and both good attitude and practice were 33 &#40;75&#46;0&#37;&#41;&#46; From statistical analysis <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;002</span>&#59; thus&#44; there is a significant relationship between attitude and practice of nurses in preventing the fall risk of falling for the patient &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Based on the analysis results&#44; showed that nurse who never takes part in education training and poor practice were 30 respondents &#40;62&#46;5&#37;&#41;&#46; Respondents who received training and good practice were 36 &#40;76&#46;6&#37;&#41;&#46; Statistical test results obtained <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;000</span>&#59; therefore&#44; the conclusion is there is a significant relationship between training and practice to prevent fall risk&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Discussion</span><p id="par0045" class="elsevierStylePara elsevierViewall">This study result similar to previous research from<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">11</span></a> with the same hospital characteristics conducted in Indonesia&#46; A significant relationship between nurses knowledge and practice in preventing fall risk because knowledge is the result of &#8220;knowing&#8221; and this happens after someone senses a certain object&#46; This knowledge is the dominant thing that is very important for the formation of one&#39;s actions&#44; from the experience of several studies it turns out that actions not based on good knowledge will not produce good results&#46; Practice-based on knowledge will be more lasting and not only based on knowledge&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">12</span></a> The better person knowledge will have a good impact on the prevention of patients falling in the Hospital&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">13</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Nurses with good knowledge tend to affect their practice to applied patient safety standard to prevent fall risk&#46; In this study&#44; two factors contributed to good knowledge are education training and age of nurses&#46; Nurses in inpatient ward aged &#60;40 years categorised as young nurses and influenced their knowledge about patient safety&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">This study showed a significant relationship between attitude and practice of nurses in the prevention of fall risk and similar to the previous study from&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">14</span></a> Attitude is a reaction or response of someone who closed to a stimulus or object&#46; Attitude is not yet an action or activity but is a predisposition to action or practice&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">12</span></a> Nurses&#8217; attitude in supporting the implementation of patient safety is prioritised to ensure patient safety&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">15</span></a> A good nurse attitude will also have a good effect on practice because strengthen by complete facilities in the Inpatient Ward to support patient safety&#44; especially in the prevention of fall risk&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">16</span></a> Besides that&#44; good knowledge and practice will have a good effect on nurses attitudes&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">17</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">This study showed that education training had a significant relationship with nurses practice and supported by&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">11</span></a> Training can be used as a strategy specifically for behaviour change by leading to the acquisition of skills&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">18&#44;19</span></a> The participation of the training by nurses influences the prevention of falling patients because the training does not only provide the prevention of falling patient material&#44; but nurses can observe directly how good fall patient prevention practices as practised by nurse trainers&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">11</span></a> The participation of nurses in training will also have a good effect on practice&#46; Nurses in this study already involved in training and showed good practice&#46; This evidence proves that training influences nurses practice in preventing the risk of falling patients&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conflict of interest</span><p id="par0065" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">This study aimed was to describe related factors of nurse practice in preventing fall risk in an inpatient ward at X General Local Hospital&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A descriptive&#44; analytical quantitative with a cross-sectional approach was used in this study&#46; The total of 95 nurses agreed to participate by using random sampling&#46; Data collection using a structured questionnaire and observational form&#46; The statistical model with a chi-square analysis was used in this study&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The result showed a correlation between knowledge and nurse practice with OR 3&#46;257 &#40;1&#46;375&#8211;7&#46;715&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;012</span>&#41;&#44; attitude and nurse practice with OR 4&#46;286 &#40;1&#46;775&#8211;10&#46;345&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;002</span>&#41; training and nurse practicewith OR value 5&#46;455 &#40;2&#46;233&#8211;13&#46;322&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;000</span>&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Local authority in the hospital must apply patient safety standards to reduce injury rates&#44; both nurses and patients&#46; Nurses need to follow the current trend of nursing science focusing on patient safety&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Peer-review under responsibility of the scientific committee of the 3rd International Conference on Healthcare and Allied Sciences &#40;2019&#41;&#46; Full-text and the content of it is under responsibility of authors of the article&#46;</p>"
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                  \t\t\t\t">54 &#40;56&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">23 &#40;44&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;257&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12 &#40;27&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">30 &#40;58&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;41&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos