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Inpatient Falls (inpatient + fall)
Selected AbstractsInpatient falls in adult acute care settings: influence of patients' mental statusJOURNAL OF ADVANCED NURSING, Issue 8 2010Huey-Ming Tzeng tzeng h.-m. (2010) Inpatient falls in adult acute care settings: influence of patients' mental status. Journal of Advanced Nursing,66(8), 1741,1746. Abstract Title.,Inpatient falls in adult acute care settings: influence of patients' mental status. Aim., This paper is a report of a study of fallers' mental status as one of the patient-related intrinsic risk factors for falls. Background., Whether confusion is one of the most important risk factors associated with risk of falling in hospital settings is unclear. Literature reviews have not identified consistent evidence for effective preventive interventions for patients with mental status deficits. Methods., This retrospective research was conducted in six adult acute care units in a community hospital in the United States of America. The data source was the 1017 fall incidents occurring between 1 July 2005 and 30 April 2009. Descriptive statistics and Pearson chi-square tests were used to analyse the data. Results., The presence of mental status deficits was identified as the dominant issue in 346 (34%) falls. The group of fallers with mental status deficits (32·1%, n = 111) seemed to have fewer toileting-related falls than those without mental status deficits (46·7%, n = 314). Fallers with mental status deficits tended to have more severe fall injuries than those without mental status deficits (,2 = 10·08, d.f. = 3, P = 0·018). Conclusion., Risk assessment and targeted surveillance should be used as part of falls prevention policy. Involving nursing staff and family members in assessing a patient's mental status may help to prevent falls caused by mental status deficits. [source] Predictors of serious injury among hospitalized patients evaluated for falls,,JOURNAL OF HOSPITAL MEDICINE, Issue 2 2010Sara M. Bradley MD Abstract BACKGROUND: Inpatient falls are common and result in significant patient morbidity. OBJECTIVE: To identify predictors of serious injury being found on imaging studies of inpatients evaluated after a fall. DESIGN: Retrospective study. SETTING: An 1171-bed urban academic medical center. PATIENTS: All inpatients who fell on thirteen medical and surgical units from January 1 to December 31, 2006. MEASUREMENTS: Patient characteristics, circumstances surrounding falls, fall-related injuries, and length of stay were collected through review of incident reports and computerized medical records. Primary outcome of fall-related injury was determined by evidence of injury on imaging studies within two weeks of the fall. Univariate and multivariate logistic regression were used to calculate adjusted odds ratios (ORs) for injury after an inpatient fall. RESULTS: A total of 513 patients had 636 falls during the study time period. Fall incidence rate was 1.97 falls per 1,000 patient days. 95 patients (19%) fell multiple times (range, 2-6 events); 74% of the falls occurred in patients who were previously assessed as being "at risk" by the nursing staff. Multivariate analysis, adjusting for age and sex, found evidence of trauma after a fall (OR = 24.6, P < 0.001) and ambulatory status (OR = 7.3, P < 0.01) to be independent predictors of injury being found on imaging studies. CONCLUSIONS: Inpatient falls are common despite high-risk patients being identified. After adjusting for age and sex, evidence of trauma and ambulatory status were independent predictors of an injury being found on imaging studies after an inpatient fall. Journal of Hospital Medicine 2010;5:63,68. © 2010 Society of Hospital Medicine. [source] Heights of occupied patient beds: a possible risk factor for inpatient fallsJOURNAL OF CLINICAL NURSING, Issue 11 2008Huey-Ming Tzeng PhD Aims., The aim of this study was to ascertain the average height of occupied patient beds in a general medical ward and to investigate the relationship between staff working-height for patient beds, time and whether the patient was on fall precaution. Background., The height of occupied patient beds can be an overlooked contributor to inpatient falls. Better physical design of hospital equipment such as patient beds may reduce patient falls and injuries. Methods., This study took place in an acute medical ward of a Michigan medical center. One researcher collected all the data and used the same metric for all the measurements. Univariate analyses were performed. Results., The average staff working-height measurement taken at the weekend was significantly higher than that taken on weekdays. The average height of patient beds on fall precaution was significantly higher than of those not on fall precaution. Conclusions., A higher patient/nurse ratio at weekends than on weekdays may result in fewer bedside nursing hours and nurses being less conscientious about keeping beds in the low position after treatments. In an effort to prevent high-fall-risk patients from falling, nurses may have consciously or unconsciously kept their beds in higher positions. Relevance to clinical practice., If the patient bed can be manually or automatically adjusted, nurses must lower the height of the bed to the lowest position after completing treatments or tasks. This after-procedure activity should be enforced and monitored regularly as part of a hospital's patient fall prevention programme. Low beds should be used for patients at high risk of falling. Future research should investigate patients' and staff's views on hospital equipment to provide evidence-based information for policy-makers determining the design-regulation standard for hospital bedframes. [source] | ||||||||||