Situating Preventive Action in a Moral and Clinical Context: A Qualitative Synthesis on Fall Prevention.

The prevention of falls is an integral part of the safety culture of health institutions with mandatory fall prevention programs set within health care facilities. Care providers are key in identifying the risks of falls and in implementing strategic actions to prevent them. With the aim to better understand practices of fall prevention, we conducted a synthesis of qualitative evidence on care providers' practices to prevent older people from falling in health care facilities. This synthesis is part of an integrative review of the role of care providers in fall prevention of adults aged 65 years and above. Primary studies were synthesized with the emerging core category of "a complex decision" and described by four emerging conditions that make that decision complex: (a) permanent threat of a fall, (b) continuous flow of information, (c) lack of control, and (d) ethical dilemmas and moral issues over the course of action. The present synthesis shows that before implementing preventive actions, care providers consider the conditions in which they are immersed, in this way situating their preventive actions in a clinical and a moral context.