Effects of Nursing Models to Prevent Falls Based on the Transforming Care at the Bedside Concept: TCAB in in-patient medical units at Sappasitthiprasong Hospital

Abstract

This research and development study aimed to develop a nursing model to prevent falls by reforming bedside care based on the Transforming Care at the Bedside (TCAB) concept and study its effects on internal medicine patients. The sample of the study was 186 patients admitted to the general internal medicine wards of the Sappasitthiprasong Hospital in Ubon Ratchathani province, Thailand, and 60 professional nurses. The development process consisted of 3 phases: 1) conducting a current situation analysis using focus group interviews with nurses; 2) development of a nursing model to prevent falls by reforming bedside care based on the relevant evidence; and 3) implementation of the nursing model. Qualitative and quantitative data were analyzed using content analysis and descriptive statistics and inferential statistics, including paired t-tests, independent t-tests, and chi square tests.

Results: The study found that the TCAB nursing model for fall prevention was comprised of four aspects, including 1) safety and reliability, 2) teamwork, 3) patient-centered care, and 4) value-added care processes. After implementing the nursing model, the incidence of falls decreased from 3.23% to 0%, but was not statistically significant (p =.081). However, the percentage of nursing practices aimed at preventing falls statistically significantly increased from 36.56% to 70.97% at p = .000. Additionally, patient/relative and nurse satisfaction with the nursing model increased significantly at p = .01. Therefore, the TCAB nursing model for fall prevention can be implemented to reduce fall incidents among internal medicine patients, leading to improved nursing quality in care processes and enhanced patient safety.