Fall prevention in hospitalised patients – intervention programmes
Authors:
H. Hajduchová; I. Brabcová; V. Tóthová; S. Bártlová
Published in:
Geriatrie a Gerontologie 2017, 6, č. 3: 117-122
Category:
Review Article
Overview
The falls of hospitalized patients are one of the most common undesirable events in elderly patients. The incidence of falls increases with the age of the patients. Serious injuries to patients may result from falls, which cause hospitalization to be prolonged. The economic impact for healthcare providers is also considerable. Developing effective precautions to prevent them is important for patient safety and maintaining hospital care quality. Falls in medical settings have attracted a certain amount of research during the past three decades. Studies have suggested that focusing precautions on individual components of falls and fall risks has been unsuccessful in significantly reducing falls. Due to the multitude of factors that play a role in patient falls, most successful fall reduction programmes have implemented simultaneous strategies.
KEYWORDS:
intervention programs – hospitalized patients – prevention of falls
Sources
1. DiBardino D, Cohen ER, Didwania A. Meta-analysis: multidisciplinary fall prevention strategies in the acute care in patient population. J Hosp Med 2012; 7(6): 497−503.
2. Ganz DA, et al. Preventing falls in hospitals: A toolkit for improving quality of care. Prepared by RAND Corporation, Boston University School of Public Health, and ECRI Institute under Contract No. HHSA290201000017I TO #1. AHRQ Publication No. 13-0015-EF. 2013. Rockville, Maryland: Agency for Healthcare Research and Quality.
3. Gallardo M, Asencio J, Sanchez J, et al. Instruments for assessing the risk of falls in acute hospitalized patients: A systematic review protocol. Journal of Advanced Nursing 2012; 69 (1): 185−193.
4. Fischer I, Krauss M, Dunagan W, et al. Patterns and predictors of inpatient falls and fall-related injuries in a large academic hospital. Infection Control & Hospital Epidemiology 2005; 26(10): 822−827.
5. Kolin, MM, Minnier T, Hale KM, et al. Fall initiatives: redesigning best practice. J Nurs Adm 2010; 40(9): 384−391.
6. Wong C, et al. The Cost of Serious Fall-Related Injuries at Three Midwestern Hospitals. The Joint Commission Journal on Quality and Patient Safety 2011; 37(2): 81−87.
7. Miake-Lye IM, Hempel S, Ganz DA, et al. Inpatient Fall Prevention Programs as a Patient Safety Strategy: A Systematic Review. Ann Intern Med 2013; 158: 390−396.
8. Weinberg J, Proske D, Szerszen A, et al. An inpatient fall prevention initiative in a tertiary care hospital. Jt Comm J Qual Saf 2011; 37(7): 317−325.
9. Sahota O, Drummond A, Kendrick D, et al. REFINE (Reducing Falls in In-patient Elderly) using bed and bedside chair pressure sensors linked to radio-pagers in acute hospital care: a randomised controlled trial. Age and Ageing 2014; 43: 247–253.
10. Cameron ID, Gillespie LD, Robertson MC, et al. Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database Syst Rev 2012; (12):CD005465.
11. Godlock G. Implementation of an Evidence-Based Patient Safety Team to Prevent Falls in Inpatient Medical Units. MEDSURG Nursing 2016; 25(1): 17−23.
12. Leone RM, Adams RJ. Safety standards: implementing fall prevention interventions and sustaining lower fall rates by promoting the culture of safety on an inpatient rehabilitation unit. Rehabil Nurs 2016; 41: 26−32.
13. Gu YY, Balcaen K, Ni Y, et al. Review on prevention of falls in hospital settings. Chinese Nursing Research 2016; 3(1): 7−10.
14. Ayton DR, Barker AL, Morello, RT, et al. Barriers and enablers to implementation of the 6-PACK falls prevention program: a pre-implmentation study in acute hospitals participating in a cluster randomised controlled trial. PLOS one 2017.
15. Lee A, Mills PD, Watts BV. Using root cause analysis to reduce falls with injury in the psychiatric unit. Gen Hosp Psychiatry 2012; 34: 304−311.
16. Health Research & Educational Trust. (2016, October). Preventing patient falls: A systematic approach from the Joint Commission Center for Transforming Healthcare project. Chicago, IL: Health Research & Educational Trust. Accessed at: www.hpoe.org
17. Growdon ME, Shorr RI, Inouye SK. The tension between promoting mobility and preventing falls in the hospital. JAMA Intern Med 2017, Apr 24.
18. Barker AL, Morello RT, Wolfe R, et al. 6-PACK programme to decrease fall injuries in acute hospitals: cluster randomised controlled trial. BMJ 2016; 352: h6781.
19. Sentinel Event Alert. Preventing falls and fall-related injuries in health care facilities. 2015; (55): 1−5.
20. Dykes PC, Carroll DL, Hurley AC, et al. Fall prevention in acute care hospitals: a randomized trial. JAMA 2010; 304: 1912–1918.
21. Ang E, Mordiffi SZ, Wong HB. Evaluating the use of a targeted multiple intervention strategy in reducing patient falls in an acute care hospital: a randomized controlled trial. J Adv Nurs 2011; 67:1984–1992.
22. Lee DCA, Pritchard E, McDermott F, et al. Falls prevention education for older adults during and after hospitalization: a systematic review and meta-analysis. Health Educ J 2014; 73:530–44.
23. Haines TP, Hill AM, et al. Patient education to prevent falls among older hospital inpatients: A randomized controlled trial. Archives of internal medicine 2011; 171(6): 516−524.
24. Haines T, Hill AM, Hill K, et al. Cost effectiveness of patient education for the prevention of fall in hospital: Economic evaluation from a randomized controlled trial. BMC Medicine 2013.
25. Tzeng HM, Yin CY. Perspectives of recently discharged patients on hospital fall-prevention programs. Journal of nursing care quality 2009; 24(1): 42−49.
26. Hill AM, McPhail S, et al. A randomized trial comparing digital video disc with written delivery of falls prevention education for older patients in hospital. Journal of the American Geriatrics Society 2009; 57(8): 1458−1463.
27. Clarke HD, Timm VL, et al. Preoperative patient education reduces in-hospital falls after total knee arthroplasty. Clinical Orthopaedics & Related Research 2012; 470(1): 244−249.
28. Hill AM, McPhail SM, Francis-Coad J, et al. Educators’ perspectives about how older hospital patients can engage in a falls prevention education programme: a qualitative process evaluation. BMJ Open 2015; 5:e009780.
29. Hook ML, Devine EC, Lang NM. Using a computerized fall risk assessment process to tailor interventions in acute care. In: Henriksen K, eds. Advances in Patient Safety: New Directions & Alternative Approaches. Washington, 2008. DC: AHRQ.
30. Haines TP, Hill AM, Hill KD, et al. Patient Education to Prevent Falls Among Older Hospital Inpatients: A Randomized Controlled Trial. Arch Intern Med 2010, ePublication.
31. Haines TP, Bennell KL, et al. Effectiveness of targeted falls prevention programme in subacute hospital setting: randomised controlled trial. BMJ 2004; 328(7441): 676.
32. Healey FA, Monro, et al. Using targeted risk factor reduction to prevent falls in older in-patients: a randomised controlled trial. Age and ageing 2004; 33(4): 390−395.
33. Vassallo MR, Vignaraja, et al. The Effect of Changing Practice on Fall Prevention in a Rehabilitative Hospital: The Hospital Injury Prevention Study. Journal of the American Geriatrics Society 2004; 52(3): 335−339.
34. Fonda D, Cook J, Sandler V, et al. Sustained reduction in serious fall-related injuries in older people in hospital. Med J Aust 2006; 184: 379–382.
35. Renteln-Kruse W, Krause T. Incidence of in-hospital falls in geriatric patients before and after the introduction of an interdisciplinary team-based fall-prevention intervention. Journal of the American Geriatrics Society 2007; 55(12): 2068−2074.
36. Stenvall M, Olofsson B, Lundstrom M, et al. A multidisciplinary, multifactorial intervention program reduces postoperative falls and injuries after femoral neck fracture. Osteoporos Int 2007; 18: 167−75.
37. Cumming RG, Sherrington C, et al. Cluster randomised trial of a targeted multifactorial intervention to prevent falls among older people in hospital. BMJ 2008; 336(7647): 758−760.
38. Tzeng HM. Nurses‘ caring attitude: Fall prevention program implementation as an example of its importance. Nursing Forum 2011; 46(3): 137−145.
39. Graham B. Examining evidence-based interventions to prevent inpatient falls. Medsurg Nursing 2012; 21(5): 267−270.
40. Bursiek AA, Hopkins MR, Breitkopf DM, et al. Use of High-Fidelity Simulation to Enhance Interdisciplinary Collaboration and Reduce Patient Falls. J Patient Safe 2017, Mar 7.
41. Wilbert WU. The effectiveness of a fall prevention/management program in reducing patient falls: A retrospective study. The Journal of Chi Eta Phi Sorority 2013; 57(1): 24−27.
42. Dias M, Oliveira SA, Martins T, et al. Medication fall risk in old hospitalized patients: A retrospective study. Nurse Education Today 2014; 34: 171–176.
43. Mion L, Chandler AM, Waters T, et al. Is it possible to identify risks for injurious falls in hospitalized patients? Joint Commission Journal of Patient Safety 2013; 38: 408–413.
44. Tool 3I: Medication Fall Risk Score and Evaluation Tools. Content last reviewed January 2013. Agency for Healthcare Research and Quality, Rockville, MD.
45. Rumore MM, Vaidean G. Development of a Risk Assessment Tool for Falls Prevention in Hospital Inpatients Based on the Medication Appropriateness Index (MAI) and Modified Beer‘s Criteria. Inov Pharm 2012; 3(1): Article 73.
46. Beasley B, Patatanian E. Development and implementation of a pharmacy fall prevention program. Hosp Pharm 2009; 44: 1095−1102.
47. Callahan L, McDonald S, Voit D, et al. Medication review and hourly nursing rounds: an evidence-based approach reduces falls on oncology inpatient units. Oncol Nurs Forum 2009; 36(3): 72.
48. Geffre S. Fall prevention program: bed alarms, investigating their impact on fall reduction and restraint use. New Britain, CT: Stanley Healthcare Solutions. November 15, 2012.
49. Tzeng HM, Yin CY. Heights of occupied patient beds: a possible risk factor for inpatient falls. J Clin Nurs 2008; 17: 1503−1509.
50. Browne JA, Covington BG, Davila Y. Using information technology to assist in redesign of a fall prevention program. J Nurs Care Qual 2004; 19(3): 218−225.
51. Diduszyn J, Hofmann MT, Naglak M, et al. Use of wireless nurse alert fall monitor to prevent inpatient falls. J Clin Outcomes Manage 2008; 15(6): 293−296.
52. Votruba L, Graham B, Wisinski J, et al. Video Monitoring to Reduce Falls And Patient Companion Costs For Adult Inpatients Nursing Economics 2016; 34(4): 185−189.
53. Tzeng HM. Inpatient falls in adult acute care settings: influence of patients’ mental status. Journal of Advanced Nursing 2010; 66(8): 1741–1746.
54. Mccurley J, Pittman JA. New approach to fall prevention in inpatient care. Patient Safety & Quality Healthcare 2014; 11(6): 50–53.
55. Pati D, Valipoor S, Cloutier A, et al. Physical Design Factors Contributing to Patient Falls. J Patient Saf 2017.
Labels
Geriatrics General practitioner for adults Orthopaedic prostheticsArticle was published in
Geriatrics and Gerontology
2017 Issue 3
Most read in this issue
- Should patients with dementia be allowed to drive?
- Fall prevention in hospitalised patients – intervention programmes
- Senior citizens in traffic – a topic to concern ourselves with?
- Alois Alzheimer and Oskar Fischer – 110th anniversary of important publications on dementia