Certified Nursing Aides’ and Care Assistants’ Views on Falls: Insight for Creation and Implementation of Fall Prevention Programs

Objectives This study examines the views of certified nursing aides (CNAs) and care assistants (CAs) regarding falls to inform fall prevention programs. Design and Methods A qualitative study of 55 CNAs and 22 CAs, comprising 13 focus groups, was conducted with an extensive content analysis of open-ended, falls-related questions. Results Functional status, followed by underlying illness, were the most common fall risk factors mentioned by both CNA and CA groups. All groups discussed reporting falls to a supervisor and examining the patient for injury. Thirty-one percent (4/13) of the groups noted reporting falls to a physician. Fifty-four percent (7/13) mentioned knowledge of documenting falls; no group participated in fall incident reviews. The most common response to a resident fall was to watch at-risk residents more closely if possible given staffing levels. No group felt that they needed more training on falls management and/or prevention. Three groups concluded that falls were not preventable. Conclusion These results suggest that frontline staff likely need education and have yet to be brought into the falls documentation and/or prevention process. Effective interventions need to include frontline staff, while recognizing the constraints of staff shortages and attitudes.