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Background <p>Inpatient falls remain a major preventable adverse event. This study addresses the critical gap by quantifying a “structural knowledge imbalance” across occupational groups, extending beyond nurse-centric approaches documented in prior literature. Current strategies predominantly focus on nursing staff, neglecting potential roles and deficiencies of other healthcare groups. This study compared fall prevention competencies among physicians, nurses, medical technicians, and logistics staff to identify disparities.</p> Methods <p>A cross-sectional survey (January–June 2025) in a tertiary hospital employed stratified cluster sampling. 787 staff completed a Knowledge, Attitude, and Practice (KAP) questionnaire, role-adapted while retaining a common core framework and uniform 4-point Likert scoring for cross-group comparability. Delphi consensus (&gt; 85% item-level agreement, mean 92%) was achieved across two rounds. Data were analyzed using one-way analysis of variance ANOVA, chi-square tests, and multiple linear regression(Enter method with cluster-robust standard errors).</p> Results <p>Significant KAP disparities were observed (<i>p</i> &lt; 0.001), with the largest effect size in knowledge (<i>η</i>² = 0.445, large effect per Cohen guidelines, indicating substantial occupational variance). Technicians scored lowest in knowledge (2.76 ± 0.33) and Morse Fall Scale (MFS) proficiency (37.29%; % of participants selecting “Very Clear” or “Clear” on the relevant item), vs. nurses (92.99%). Attitudes were generally positive, though technicians scored lower (3.31 ± 0.29). Practices were highest among nurses (3.50 ± 0.22) and logistics staff (3.50 ± 0.24), while technicians lagged (3.17 ± 0.35). Training significantly improved technician knowledge (<i>p &lt; 0.001</i>). Occupation and training predicted knowledge scores.</p> Conclusions <p>A “structural knowledge imbalance” was observed (uneven distribution of specialized knowledge across roles in a healthcare system, leading to vulnerabilities in patient safety) exists. Gaps are addressable via targeted training. We advocate role-based precision education (tailored, evidence-based training programs customized to specific occupational responsibilities and knowledge gaps) and workflow integration to enhance attitudes and practices for a resilient safety net.</p>

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Disparities in knowledge, attitudes, and practices regarding inpatient fall prevention: a multi-occupational group comparison study in a tertiary hospital in China

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  • 发表日期：

    2026年4月22日

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  • Darong Wang,
  • Yulian Yuan,
  • Xingzi Guo

摘要

Background

Inpatient falls remain a major preventable adverse event. This study addresses the critical gap by quantifying a “structural knowledge imbalance” across occupational groups, extending beyond nurse-centric approaches documented in prior literature. Current strategies predominantly focus on nursing staff, neglecting potential roles and deficiencies of other healthcare groups. This study compared fall prevention competencies among physicians, nurses, medical technicians, and logistics staff to identify disparities.

Methods

A cross-sectional survey (January–June 2025) in a tertiary hospital employed stratified cluster sampling. 787 staff completed a Knowledge, Attitude, and Practice (KAP) questionnaire, role-adapted while retaining a common core framework and uniform 4-point Likert scoring for cross-group comparability. Delphi consensus (> 85% item-level agreement, mean 92%) was achieved across two rounds. Data were analyzed using one-way analysis of variance ANOVA, chi-square tests, and multiple linear regression(Enter method with cluster-robust standard errors).

Results

Significant KAP disparities were observed (p < 0.001), with the largest effect size in knowledge (η² = 0.445, large effect per Cohen guidelines, indicating substantial occupational variance). Technicians scored lowest in knowledge (2.76 ± 0.33) and Morse Fall Scale (MFS) proficiency (37.29%; % of participants selecting “Very Clear” or “Clear” on the relevant item), vs. nurses (92.99%). Attitudes were generally positive, though technicians scored lower (3.31 ± 0.29). Practices were highest among nurses (3.50 ± 0.22) and logistics staff (3.50 ± 0.24), while technicians lagged (3.17 ± 0.35). Training significantly improved technician knowledge (p < 0.001). Occupation and training predicted knowledge scores.

Conclusions

A “structural knowledge imbalance” was observed (uneven distribution of specialized knowledge across roles in a healthcare system, leading to vulnerabilities in patient safety) exists. Gaps are addressable via targeted training. We advocate role-based precision education (tailored, evidence-based training programs customized to specific occupational responsibilities and knowledge gaps) and workflow integration to enhance attitudes and practices for a resilient safety net.