TABLE 4.
Additional risk factors identified by this qualitative study
| Domain and sub‐domain in theoretical framework | Risk factor |
|---|---|
| Medication | Anaesthetic leading to hallucination |
| Mobility | Being designated a falls risk |
| Mobility (environmental) | Chairs being too low |
| Beds being set too high | |
| Cluttered corridors/crowded ward obstructed for walking | |
| Mobility (process of care) | Patient not being seen by physiotherapist |
| Staff not having easy access to equipment e.g. walking aids, Zimmer frames | |
| Additional patient factors | Patient loss of confidence |
| Patient motivation, desires and beliefs of what is expected of them | |
| Patient finds details of process of care overwhelming | |
| Patient adherence to planned care (patient level of compliance, defiance) | |
| A lack of patient awareness about MoF | |
| Poor external support (advocate/family) | |
| Loss of usual routine | |
| Patients not having their own belongings | |
| Difficulty using buzzer | |
| Additional patient factors (ward culture) | Encouraging patients to be independent is not the norm or encouraged by leadership |
| Taking away opportunities for the patient to be independent (e.g. use of bottles, commodes and bedpans rather than trips to the toilet) | |
| Lack of stimulation (patients being left for long periods) and feeling isolated particularly when in side rooms | |
| Additional patient factors (process of care) | Not allowing patients to administer their own medication |
| Inadequate communication among the MDT about therapy goals | |
| Lack of communication, continuity and familiarity between patients and staff (e.g. staff not introducing themselves to patients) | |
| Additional patient factors (environmental) | Nowhere for patients to go or sit |
| No phone signal and no alternative phone to use | |
| Stressful environment | |
| Contextual risk factors (process of care) | Not gathering information about the patients functional history |
| Failure of staff to act on information provided by patient/carer about functional ability, medication and care needs | |
| Post discharge care and communication lacking | |
| Delays in post discharge social care | |
| Contextual risk factors (cultural) | Risk aversion/patient safety taking precedence over patient's needs that is, treating all patients as high risk regardless of actual risk |
| Contextual risk factors (organizational) | Time consuming paperwork |
| Difficulty locating patient notes | |
| High staff turnover | |
| Not enough staff | |
| Staff not having enough time | |
| Staff not having enough training on MoF |