Eficácia de aplicativo móvel para prevenção de quedas por meio da Nursing Outcomes Classification: ensaio clínico randomizado

Abstract

Introduction: Patient falls are high¬impact events in hospital settings, requiring effective prevention strategies. Nursing can incorporate technological resources to enhance care quality, with mobile applications standing out due to their good acceptance and effectiveness in educational actions. The effects of these interventions can be evaluated through the Nursing Outcomes of the Nursing Outcomes Classification (NOC), which provide standardized measures to assess patient responses to preventive actions. Objective: To evaluate the effectiveness of a mobile application in improving patients’ Knowledge: Fall Prevention and Fall Prevention Behavior during hospitalization, using the NOC framework. Methods: A randomized clinical trial was conducted in a Brazilian university hospital between October 2023 and June 2024 with 61 adult patients hospitalized for up to 24 hours and diagnosed with the Nursing Diagnosis “Risk for Falls.” Participants were randomly assigned to either the Control Group (n=30), which received routine care, or the Intervention Group (n=31), which received an educational intervention delivered via mobile application. The NOC outcomes — Knowledge: Fall Prevention, Fall Prevention Behavior, and Safe Health Care Environment — were assessed, along with a fall¬prevention knowledge test, at baseline, 24 hours after the intervention, and on the third and seventh days. Indicator scores were analyzed using a fivepoint Likert scale and mean test scores. The study was approved by the Research Ethics Committee (protocol nº 5.082.265). Results: Participants were predominantly male (55.74%), with a mean age of 41.1 ± 15.5 years. Most self¬identified as White (59.02%), were professionally active (63.93%), married (57.38%), and had 12 years of schooling (36.07%). Analysis of NOC outcomes indicated knowledge levels ranging from limited to moderate (mean = 2.98) and preventive behavior classified as occasionally demonstrated (mean = 3.13). Over the follow¬up period, improvements were observed in five knowledge indicators: appropriate footwear use, correct use of grab bars, understanding of diseases that increase fall risk, blood pressure changes associated with fall risk, and strategies for safe ambulation. Advances were also noted in three behavior indicators: use of bathroom grab bars for hand support, use of appropriate footwear for fall prevention, and proper use of the bed. The Safe Health Care Environment outcome (1934) showed no relevant variations across assessment points, remaining between moderate and fully adequate levels (mean = 4.43). In the knowledge test, the Intervention Group demonstrated a marked increase in mean scores. Conclusions: The results showed that the mobile application was effective in improving NOC outcomes and knowledge test scores among participants in the intervention group compared with the control group. In this context, the Nursing Process emerges as an essential tool for planning, implementing, and evaluating actions aimed at fall prevention, integrating NOC outcomes into clinical practice.