Falls and consequent injuries in hospitalized patients: Effects of an interdisciplinary falls prevention program

Article (PDF Available)inBMC Health Services Research 6(1):69 · February 2006with60 Reads
DOI: 10.1186/1472-6963-6-69 · Source: PubMed
Abstract
Patient falls in hospitals are common and may lead to negative outcomes such as injuries, prolonged hospitalization and legal liability. Consequently, various hospital falls prevention programs have been implemented in the last decades. However, most of the programs had no sustained effects on falls reduction over extended periods of time. This study used a serial survey design to examine in-patient fall rates and consequent injuries before and after the implementation of an interdisciplinary falls prevention program (IFP) in a 300-bed urban public hospital. The population under study included adult patients, hospitalized in the departments of internal medicine, geriatrics, and surgery. Administrative patient data and fall incident report data from 1999 to 2003 were examined and summarized using frequencies, proportions, means and standard deviations and were analyzed accordingly. A total of 34,972 hospitalized patients (mean age: 67.3, SD +/- 19.3 years; female 53.6%, mean length of stay: 11.9 +/- 13.2 days, mean nursing care time per day: 3.5 +/- 1.4 hours) were observed during the study period. Overall, a total of 3,842 falls affected 2,512 (7.2%) of the hospitalized patients. From these falls, 2,552 (66.4%) were without injuries, while 1,142 (29.7%) falls resulted in minor injuries, and 148 (3.9%) falls resulted in major injuries. The overall fall rate in the hospitals' patient population was 8.9 falls per 1,000 patient days. The fall rates fluctuated slightly from 9.1 falls in 1999 to 8.6 falls in 2003. After the implementation of the IFP, in 2001 a slight decrease to 7.8 falls per 1,000 patient days was observed (p = 0.086). The annual proportion of minor and major injuries did not decrease after the implementation of the IFP. From 1999 to 2003, patient characteristics changed in terms of slight increases (female gender, age, consumed nursing care time) or decreases (length of hospital stay), as well as the prevalence of fall risk factors increased up to 46.8% in those patients who fell. Following the implementation of an interdisciplinary falls prevention program, neither the frequencies of falls nor consequent injuries decreased substantially. Future studies need to incorporate strategies to maximize and evaluate ongoing adherence to interventions in hospital falls prevention programs.

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Available from: Rene Schwendimann, Jan 24, 2015
    • "Actually, the compliance rate of nurses allowing patients to watch the animations decreased from around 100 % in postintervention survey period to 73 % in September 2014, 13 months after intervention. According to previous reports , the complexity of the fall prevention interventions led to less timely compliance by staff and resulted in a loss of potential benefit from multidisciplinary methods in spite of staff efforts [16,[39][40][41]. To overcome this issue, changing the hospital culture surrounding fall prevention plays a key role [7], and leadership support and engagement of staff in the program will enhance the effectiveness of its implementation [16]. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: In this study, we developed an animated movie as a novel educational tool for fall prevention, and intended for patients and caregivers. We evaluated this new animation, comparing its effectiveness both before and after intervention, and have discussed its potential in the context of inpatient fall prevention. Methods: While including previously implemented multidisciplinary fall prevention measures, we started to introduce the use of animation in August 2013. Pre-and post-intervention questionnaire surveys were conducted for patients and nurses in June and August 2013, respectively, for 2 weeks.
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    • "In a psychiatric patient population study, Knight et al. [8] listed several intrinsic and extrinsic contributing factors for falls. Specific fall-related variables included cognitive status [55], psychotropic medications [29], age [56], staff training [57], staffing levels [36,37], use of restraints [58], scheduled toileting [59], evidence-based fall prevention policy [60], and uncluttered environment [35]. Robey-Williams et al. [53] in a PubMed search, found medications, patient gait, and prior falls as the top three risk factors contributing to patient falls in healthcare areas. "
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