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A qualitative investigation of injurious falls in long-term care: perspectives of staff members

Purpose. Although falls often result in serious injury among seniors residing in long-term care (LTC), there is a paucity of research about LTC staff perceptions about falls. Our purpose was to elicit opinions of LTC staff about falls and fall prevention given ‘least restraint’ policies. We also aimed to identify obstacles for optimal falls prevention. Method. Data were collected from administrators and a wide variety clinical staff (N = 98; 7 LTC facilities) using 11 focus groups and 28 interviews. Questions were asked about clinical practices related to falls. We employed thematic analysis to ascertain primary and secondary themes within the data. Results. Participants viewed falls as a major challenge. They expressed concerns about their ability to control falls and manage consequences. Participants were conflicted about the role of restraints in falls management. Although they acknowledged beneficial effects of least restraint in terms of resident independence and increased activity, they also noted that in some instances, restraints may prevent falls, especially when individuals with dementia are considered. Conclusions. Participants were highly attentive to issues surrounding falls. However, many were unaware of clinically important findings from relevant research and misperceived fall-related (restraint) policies. Physical therapists have a role to play in education initiatives targeting these areas.