Article

Risk Factors of Falls in Elderly Population in Acute Care Hospitals and Nursing Homes in North Italy

School of Nursing Pordenone, Udine University, Italy.
Journal of nursing care quality (Impact Factor: 1.39). 01/2008; 23(1):43-9. DOI: 10.1097/01.NCQ.0000303804.15080.76
Source: PubMed

ABSTRACT

A retrospective comparative study was conducted in Italy to determine whether the risk of accidental falls is the same in acute care hospitals as in nursing homes. Accidental falls were significantly related to women older than 80 years and to a hospital stay 10 days or longer, with an increased risk related to stroke, arterial hypertension, and a Norton Scale score greater than 15. Prevention strategies need to be based on the context and specific intrinsic and extrinsic factors influencing the risk of falls in elderly patients.

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    • "However, other findings have been reported; for example, there are more falls in a hospital psychiatric department [4] and in general hospitals when the patient's length of stay is more than 10 days [6]. On the other hand, patients with a tumor had a lower risk of falling [6]. This could be attributed to the fact that these patients were on bed rest most of the time, which decreased their risk of falling. "
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    ABSTRACT: The implementation of an information system has become a trend in healthcare institutions. How to identify variables related to patient safety among accumulated data has been viewed as a main issue. The purpose of this study was to identify critical factors related to patient falls through the application of data mining to available data through a hospital information system. Data on a total of 725 patient falls were obtained from a web-based nursing incident reporting system at a medical center in Taiwan. In the process of data mining, feature selection was applied as the first step, after which 10 critical factors were selected to predict the dependent variables (injury versus non-injury). An artificial neural network (ANN) analysis was applied to develop a predictive model and a multivariate stepwise logistic regression was performed for comparison purposes. The ANN model produced the following results: a Receiver-Operating-Character (ROC) curve indicated 77% accuracy, the positive predictive value (PPV) was 68%, and the negative predictive value (NPV) was 72%; while the multivariate stepwise logistic regression only identified 3 variables (fall assessment, anti-psychosis medication and diuretics) as significant predictors with ROC curve of 42%, PPV of 26.24%, and NPV of 87.12%. In addition to medication use such as anti-psychotic and diuretics, nursing intervention where a fall assessment is conducted could represent a critical factor related to outcomes of fall incidence.
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    ABSTRACT: Objective: To analyze the frequency, consequences and associated factors of accidental falls in the elderly. Methods: A literature search was made in the Medline, Cochrane and EMBASE databases for original papers on accidental falls in the elderly, their frequency, consequences, risk factors and prevention. The search centered on studies published in English and Spanish between two months of 2008, using the following keywords: accidental falls and people over 65 years of age, crossed with frequency, consequence, risk factors and prevention. Results: According to the Spanish National Statistics Institute, the frequency of falls was 51-67%, while in the na- tional and international studies the figures were 26-35% and 33-41%, respectively. The most frequent consequen- ces were luxations or contusions (60-70%). The main intrinsic risk factors were found to be advanced age, previous falls and multiple disease processes, while the extrinsic risk factors were drugs and incorrect use of walking aids. Conclusion: Accidental falls in elderly people constitute a relevant health problem with important physical as well as psychological consequences.
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    ABSTRACT: The purpose of this descriptive study was to assess whether the Humpty Dumpty Falls Scale (HDFS) identifies hospitalized pediatric patients at high risk for falls. The study was a matched case-control design. A chart review of 153 pediatric cases who fell and 153 controls who did not fall were pair-matched by age, gender, and diagnosis. High-risk patients fell almost twice as often as low-risk patients (odds ratio 1.87, confidence interval = 1.01, 3.53, p = .03). A Falls Prevention Pediatric Program with the HDFS tool addresses the Joint Commission Patient Safety Goals, but further research is needed to examine HDFS sensitivity-specificity.
    Full-text · Article · Feb 2009 · Journal for Specialists in Pediatric Nursing
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