Implementing meaningful activity facilitators to prevent hospital-acquired complications in French geriatric short-stay wards: A qualitative analysis of the context and stakeholder representations.

BACKGROUND

Rising hospitalization rates among older inpatients and their complex needs challenge traditional acute care models. Hospital-acquired complications and deconditioning remain major risks, especially when organizational constraints limit meaningful interactions. This qualitative study explored the perceived care needs for older inpatients and acceptability of Meaningful Activity Facilitators (MAFs) to address these needs in acute geriatric wards in France.

METHODS

Using a multiple data source approach, we conducted non-participatory field observations and semi-structured interviews with patients and healthcare workers in two French geriatric wards. Topics included mobility, cognition, nutrition, hydration, mood, and organizational constraints. Participants discussed the role, benefits, barriers, and implementation challenges of MAFs.

RESULTS

Staff, particularly nurses, identified understaffing and heavy workloads as key barriers to providing regular personal engagement. Patients often described insufficient contact despite acknowledging staff's interpersonal efforts. Both groups expressed support for introducing MAFs, viewing them as a means to enhance patient experience, care quality, and staff satisfaction. Concerns were raised about close teamwork, role clarity, and preventing task overlap.

CONCLUSIONS

The integration of MAFs in acute geriatric settings appears acceptable and promising for enhancing patient interaction and potentially reducing complications such as delirium or deconditioning. Careful planning, training, and role definition will be critical for successful deployment.