Exploring the influence of hospital context on acute care physical therapy fall prevention practice: A qualitative study.
James P Crick, Gideon Hewitt, Lisa Juckett and 3 others
PMID 39773398WHAT IT FOUND
Ten acute care physical therapists described mobility promotion as the central fall prevention strategy, yet found it consistently blocked by nursing guidelines, staff shortages, and lack of equipment.
They viewed their role as educating nurses and planning safe discharges rather than delivering direct treatment.
Key findings
01Participants identified time constraints, institutional priorities, patient volume, staff availability, lack of equipment, and the physical environment as the six main contextual factors limiting fall prevention practice.
02Therapists perceived nursing fall prevention guidelines as promoting sedentariness through interventions like bed alarms and sitters, which were reliably implemented but mobility limiting.
03Due to high patient volumes and limited staff, therapists adjusted their focus to education and discharge planning, anticipating they might not see the patient again before discharge.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample was small (10 participants) and self-selected from a previous survey, with all members being part of the American Physical Therapy Association, which may limit generalizability to non-members or those less engaged with professional standards. The study explored perceptions and did not measure actual fall rates or patient outcomes, so it describes what therapists believe limits their practice rather than proving these factors cause falls. Participants were recruited from 10 different hospital systems, but the specific impact of different hospital sizes or types (e.g., rural vs. urban) was not deeply analyzed beyond the general themes of resource scarcity.
Declared interests
The paper does not explicitly state a funding source or conflict of interest declaration in the provided text, but notes IRB approval and that one researcher was a practicing acute care physical therapist.
The easy way to misread this
Do not interpret these findings as evidence that mobility promotion reduces falls. The study reports therapists' perceptions of barriers and their adapted practices, not clinical outcomes or efficacy data.