Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)




Within the United States, falls are the largest category of adverse events reported in hospitals. Injuries associated with falls include increased costs, extended length of stays, increased mortality and morbidity, and liability to hospitals. The purpose of this study was to discover, describe, and systematically analyze universal and diverse care meanings and expressions of adults experiencing a fall while hospitalized. The research was conceptualized with the ethnographic theoretical framework of Culture Care Diversity and Universality (Leininger 2001, 2006). Data collection took place in a large academic medical center, over a five month period and included 24 participants: eight adult inpatients experiencing a fall event and sixteen registered nurses with direct knowledge about the adult inpatient fall event. Observation, participation, and ethnographic interviews were used to collect data in the research context of the participants. A systematic, rigorous, and in-depth data analysis was completed using the Data Analysis Guide (Leininger 2001, 2006) along with the Ethnograph qualitative software program (Qualis Research, 2006). Three themes emerged from the data regarding the culture of care of adults experiencing a fall while hospitalized: blaming despite vulnerability, mitigating risk, and diversity in the efficacy of staffing patterns. These findings were embedded within the social structure dimension of the hospital setting. These findings and their sociocultural influences have implications for nursing practice, administration, and education.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

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Nursing Commons