Abstract
PURPOSE
Falls remain a major patient safety concern among hospitalized older adults, particularly as previously independent individuals become acutely vulnerable during admission. Although falls prevention strategies are widely used, their implementation is often insufficiently patient-centered and may not reflect the cultural, linguistic, and organizational realities of healthcare settings in the United Arab Emirates (UAE). This study explored fall risk and prevention from the perspectives of hospitalized older adults, frontline healthcare professionals, and nurse managers in the UAE.
PATIENTS AND METHODS
A qualitative descriptive study was conducted across two acute care hospitals in the UAE. Using purposive sampling, data were collected in two phases: semi-structured interviews with hospitalized older adults aged ≥65 years (n=8); focus group discussions with nurses and allied health professionals (n=12); and nurse managers (n=15). Data was analyzed thematically, and triangulation was used to identify converging patterns across stakeholder groups.
RESULTS
Four themes were identified: (1) autonomy versus safety, (2) gaps in patient education and engagement, (3) system and environmental barriers, and (4) opportunities for innovation and patient-centered solutions. Patients often prioritized independence despite clinical vulnerability, while staff highlighted limitations in education, delayed responses to call bells, environmental hazards, and the reduced sensitivity of current risk assessment processes to dynamic clinical change. Participants across groups emphasized the need for culturally responsive education, clearer communication, and more integrated system-level approaches.
CONCLUSIONS AND FUTURE DIRECTIONS
Fall risk in hospitalized older adults is shaped by the interaction of patient behavior, communication practices, environmental conditions, and organizational responsiveness. This study contributes context-specific evidence from the UAE, showing that falls prevention should move beyond standardized risk scoring toward patient-centered, culturally responsive, and system-integrated strategies. Future research should examine whether addressing these barriers improves measurable outcomes such as fall rates, reassessment compliance, and response times.