Links between falls in hospitals and professional fulfilment, burnout, work environment and organisational culture: a scoping review.

backgroundHealthcare staff wellbeing is critical to deliver quality patient-centred care. Burnout, lack of professional fulfilment, poor work environment, and an unsupportive organisational culture - impact healthcare delivery. However, their relationship with hospital patient falls - a frequent adverse outcome remains underexplored.

objectiveThis review aimed to: (1) map the evidence investigating the relationship between staff wellbeing concepts (burnout, professional fulfilment, work environment and organisational culture) and patient falls in hospitals; and (2) determine the extent of consideration of staff wellbeing in existing hospital falls prevention trials.

methodsReview followed Joanna Briggs Institute methodology [1]. PubMed, MEDLINE, CINAHL, Embase and PsycINFO were searched from inception to July 2024. Cochrane database was searched to identify existing hospital falls prevention interventions trials. Studies mentioning at least one staff wellbeing concept, and patient falls were included.

resultsOf 11,358 records, 78 studies were included. Most were observational (n = 54), nurse-focused (n = 67), and in acute settings (n = 69). Twenty studies investigated association between staff wellbeing and patient falls- mostly cross-sectional (n = 18), only two longitudinal. Burnout was associated with increased falls; job satisfaction showed a protective role. Better work environment reduced falls. Organisational culture findings were mixed - group culture and better leadership reduced falls, while toxic leadership and development culture increased falls. Variability in definitions and measurement tools led to conceptual overlaps. No Cochrane trials considered staff wellbeing in fall prevention interventions.

conclusionEvidence linking staff wellbeing and patient falls is emerging but limited. Critical gaps include inconsistent conceptualisation, a lack of - longitudinal, multidisciplinary focused intervention research integrating these concepts. Embedding staff wellbeing into fall prevention strategies is essential. CLINICAL TRIAL REGISTRATION NUMBER: Not applicable.