Patient and system factors associated with unassisted and injurious falls in hospitals: an observational study

BMC Geriatrics

Anne M. Skinner¹  Regina Nailon²  Robin High³  Dawn M. Venema⁴  Katherine J. Jones⁴  Deborah Conley⁵ 

[1] Allied Health Research Administration, College of Allied Health Professions, University of Nebraska Medical Center;CDC Grants Office, Nebraska Medical Center;Department of Biostatistics, College of Public Health, University of Nebraska Medical Center;Division of Physical Therapy Education, College of Allied Health Professions, University of Nebraska Medical Center;Patient Care Administration, Geriatrics, Methodist Hospital;

关键词: Hospitals;    Accidental falls;    Patient safety;   

DOI  :  10.1186/s12877-019-1368-8

来源: DOAJ

【 摘 要 】

Abstract Background Unassisted falls are more likely to result in injury than assisted falls. However, little is known about risk factors for falling unassisted. Furthermore, rural hospitals, which care for a high proportion of older adults, are underrepresented in research on hospital falls. This study identified risk factors for unassisted and injurious falls in rural hospitals. Methods Seventeen hospitals reported 353 falls over 2 years. We categorized falls by type (assisted vs. unassisted) and outcome (injurious vs. non-injurious). We used multivariate logistic regression to determine factors that predicted fall type and outcome. Results With all other factors being equal, the odds of falling unassisted were 2.55 times greater for a patient aged ≥65 than < 65 (95% confidence interval [CI] = 1.30–5.03), 3.70 times greater for a patient with cognitive impairment than without (95% CI = 2.06–6.63), and 6.97 times greater if a gait belt was not identified as an intervention for a patient than if it was identified (95% CI = 3.75–12.94). With all other factors being equal, the odds of an injurious fall were 2.55 times greater for a patient aged ≥65 than < 65 (95% CI = 1.32–4.94), 2.48 times greater if a fall occurred in the bathroom vs. other locations (95% CI = 1.41–4.36), and 3.65 times greater if the fall occurred when hands-on assistance was provided without a gait belt, compared to hands-on assistance with a gait belt (95% CI = 1.34–9.97). Conclusions Many factors associated with unassisted or injurious falls in rural hospitals were consistent with research conducted in larger facilities. A novel finding is that identifying a gait belt as an intervention decreased the odds of patients falling unassisted. Additionally, using a gait belt during an assisted fall decreased the odds of injury. We expanded upon other research that found an association between assistance during falls and injury by discovering that the manner in which a fall is assisted is an important consideration for risk mitigation.

【 授权许可】

Unknown