Health Care Professionals' Views of Barriers and Facilitators for Implementing a Fall Risk Screening Tool in Clinical and Public Health Settings.

Abstract

Objective: The experiences of health care professionals using new screening tools in clinical and public health settings are crucial to the implementation process. However, further research is needed on their experiences with fall risk screening. This study utilized the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework to explore health care professionals' experiences with the First-time Injurious Falls (FIF) screening tool, aiming to identify barriers and facilitators for implementing the FIF tool in primary health care and public health settings.

Methods: A qualitative study with 4 focus group interviews and 7 individual interviews was carried out, using a semi-structured interview guide. The interviews were recorded, transcribed verbatim, and analyzed with reflexive thematic analysis. The study.included 20 participants (13 females and 7 males), with a mean age of 39 years (range 24 to 54). The participants were working in the primary health care setting (8 physical therapists, 3 occupational therapists, 3 managers, 2 registered nurses, and 1 dietician) and in a public health project (1 physical therapist and 2 health educators).

Results: The analysis resulted in 3 themes: "A valuable tool in clinical practice," "How to get everyone onboard when implementing fall risk screening," and "Applicable in many areas of health services but not in all" with 4 related subthemes "Quick and easy to use for all health care professionals," "Simplifies assessment and creates a platform for discussion," "Need for clear instructions and action list," and "Should be incorporated into daily routines."

Conclusion: The FIF tool was well-received by participants in practice as it was user-friendly and potentially effective in preventing falls. However, there is room for improvement, particularly in clarifying instructions to mitigate possible misinterpretations. The participants emphasized that implementation of a new screening tool requires favorable organizational conditions such as managerial support, that the tool is easily accessible, and the results are easy to document.

Impact: The FIF tool seems to be a valuable screening tool for predicting first-time injurious falls in older adults, suitable for use by various health care professionals.