Modelling Human Performance: The Key to fall prevention

Introduction

There is little evidence supporting the efficacy of most fall prevention interventions in hospitals. Current interventions rely on education of patients, which has limited use for those with cognitive impairment.  Technology has the potential to support the prevention of accidental inpatient falls (AIF) but results from prior studies are inconclusive. This study aimed to gain insights from healthcare professionals (HCPs) about managing AIF in secondary care. 

Method

A multi-site, qualitative, simulation study with HCPs was implemented to explore their experiences of AIF. Purposive sampling across 3 NHS Trusts recruited 51 HCPs to 18 simulations and 9 focus groups. Thematic analysis was undertaken to understand barriers to AIF prevention. The Human Information Processing (HIP) Model was utilised to interpret the data, explaining how humans perceive, process, store and respond to information.

Results

Examination of the data using the HIP tells us that a well-designed system of work using technology improves nurses’ situation awareness. Allowing decisions to be made at a subconscious level, whilst conserving cognitive resources. Whilst technology delivers cues and feedback to users it also has the potential to relieve attention demand and provide insights to workable user centred solutions for fall prevention.  Leadership, systems and culture are influential but a technology-based resource may support system design and result in culture change that drives patient safety.

Conclusion

From the perspectives of HCPs decision making regarding AIF is complex. Technology may assist with situation awareness and help highlight where cognitive load is exceeding the capacity to cope.  HIP was found to be a useful tool to break down complex decision scenarios and understand technology design features contributing to AIF prevention. By improving visibility of high risk situations, technology can help timely decision making.