Effect of nurses' resilience on fall prevention in acute-care hospital: a mixed-methods qualitative study.

Aims To understand the distinctive experience and use of strategies of high- and low-resilience nurses aiming to prevent patient falls. Background Falls among inpatients continue to threaten patient safety in the hospital. Nurses may have the greatest impact on reducing patient falls. However, little is known about whether nurses' personal resilience is associated with patients' fall-prevention strategies. Method The study employed a descriptive mixed-methods design combining quantitative (questionnaires) and qualitative (observations, semi-structured interviews). Results One major theme, from maintaining routine to taking control over patients' falls, and three sub-themes: skepticism, anticipation, and proactivity representing feelings, cognitions, and behaviors characterizing high- versus low-resilience nurses emerged from the findings. Conclusion Three successive resilience strategies, starting with hunches that elicit skepticism, through cognitions of anticipation the worst-case scenario that could happen to the patient, and concluding with proactive behaviors characterize resilient nurses, helping them to prevent patients' falls. Implication for nursing management Nursing managers seeking to decrease the devastating rate of patient falls, can encourage nurses to have an inquiring mind (skepticism), be alert for the unexpected (anticipation), and take control over the environment (proactive behaviors) to make things happen instead of watching them happen.