Understanding the situation and challenges of falls prevention work in clinical settings for geriatric healthcare in China: a mixed-method study

Falls are a major public health concern in rapidly ageing countries. While guidelines for preventing falls exist, their application remains arduous. This study aimed to understand the situation and challenges of falls prevention work in Chinese clinical practices for geriatric healthcare. A mixed-methods convergent design was used with a nationwide quantitative survey and qualitative interviews. Geriatricians, general practitioners, and nurses from tertiary/secondary hospitals and community healthcare centres were recruited via purposive and snowball sampling. Domains and themes were developed following the integration of the two results (survey and interview)—focused on falls prevention status and implementation barriers—within the framework of the 2022 World Falls Guideline. Three domains and nine themes were identified. The domains were (1) The extent of falls prevention practices, (2) Understanding on the clinical importance and effectiveness of falls prevention, and (3) Challenges in implementing falls prevention programs. The themes were (1) Systematic falls prevention was not widely conducted, (2) Fewer practices in community healthcare centres versus secondary and tertiary hospitals, (3) Wards implemented more clinical practices than outpatient settings, (4) Falls were not deemed as a primary concern in clinical practice, (5) Scepticism about the effectiveness of interventions, (6) How to select patients? (7) Inadequate competence in assessment and intervention, (8) A lack of integrated care and pathways, and (9) Financing challenges. This study concluded that while the importance of falls prevention was widely recognized in both outpatient and inpatient settings, its implementation remained unsystematic. Narrowing the knowledge-to-practice gap is a key priority for geriatric healthcare settings when rolling out evidence-based falls prevention initiatives.