Retrospective analysis of patient falls as a basis for evidence-based practice

Jana Horová 1,2, Iva Brabcová 2, Nina Müllerová 3
1University of South Bohemia in České Budějovice, Faculty of Health and Social Sciences, České Budějovice, Czech Republic 2University of West Bohemia in Pilsen, Faculty of Health Care Studies, Plzeň, Czech Republic 3University Hospital in Pilsen, Plzeň, Czech Republic

Korespondenční autor: Jana Horová (jhorova@kos.zcu.cz)

ISSN 1804-7181 (On-line)

Full verze:
Full version

Submitted:2. 7. 2018
Accepted: 22. 10. 2018
Published online: 31. 12. 2018

Summary

Aims: The aim of this work was to perform a five-year retrospective analysis of patient falls at the Regional University Hospital, as a basis for preventive programme implementation based on the evidence-based practice. Methods: The obtained data were processed by quantitative research methods. Descriptive statistics were obtained from patient fall report forms that were completed mandatorily over a five-year period. In the next phase, data correlation was performed, and areas in which the preventive anti-fall programmes are performed were determined at the significance level of 5%. The Stata of version 13 was used. The SPSS Answer Tree of version 3.1 was used to identify risk groups. Results: The Regional University Hospital is one of the largest healthcare facilities in the Czech Republic, with 1,729 beds and 4,480 employees. The analysis included a total of 2,280 patient falls that occurred over the fiveyear period. The data obtained by the descriptive statistics were correlated with the fall-risk area (chi-squared test). The statistically significant relationships seemed to be: year of monitoring, department, type of ward, age, mental condition, medication use, antipsychotics, cardiovascular drugs, diuretics, medication category, circumstances of fall, patient cooperation, patient mobility and post-fall development. Conclusion: The processing of patient fall incidence information as one of the most common adverse events in a hospital is relevant for national and transnational comparison. It may be an inspirational incentive for a more effective programme to prevent falls and fall-related injuries in other healthcare facilities.

Keywords: Adverse event; Evidence-based practice; Fall; Hospital; Patient; Retrospective analysis

Literatura

1. Botíková A, Heššová A, Puteková S (2015). Formation and prevention of falls in the elderly. In: Mikšová Z (Ed.). Profesionalita v ošetřovatelství II. Olomouc: Univerzita Palackého v Olomouci, pp. 21–29.

2. Brabcová I, Hajduchová H, Bártlová S, Tóthová V (2016). Retrospective analysis of falls in selected hospitals of the Czech Republic. Neuro Endocrinol Lett 37(2): 18–24.

3. Frankel A, Haraden C, Federico F, Lenoci-Edwards J (2017). A Framework for Safe, Reliable, and Effective Care. White Paper. Cambridge, MA: Institute for Healthcare Improvement and Safe & Reliable Healthcare. [online] [cit. 2018–06–22]. Available from: http://www.ihi.org/…urces/Pages/ IHIWhitePaper­s/Framework-Safe-Reliable-Effective-Care.aspx

4. Haines TP, Bell RA, Varghese PN (2010). Pragmatic, cluster randomized trial of a policy to introduce low-low beds to hospital wards for the prevention of falls and fall injuries. J American Geriatr Soc 58(3): 435–441. DOI: 10.1111/j.1532–5415.2010.02735.x.

5. Haines TP, Hill A-M, Hill K, Brauer S, Hoffmann T, Etherton-Beer Ch, McPhail S (2013). Cost effectiveness of patient education for the prevention of falls in hospital: economic evaluation from a randomized controlled trial. BMC Medicine 11: 135. DOI: 10.1186/1741–7015–11–135.

6. Hill AM, Hoffmann T, Hill K, Oliver D, Beer C, McPhail S, et al. (2010). Measuring Falls Events in Acute Hospitals-A Comparison of Three Reporting Methods to Identify Missing Data in the Hospital Reporting System. J Am Geriatr Soc (58)7: 1347–1352. DOI: 10.1111/j.1532–5415.2010.02856.x.

7. Horová J, Brabcová I, Krocová J (2017). The effectiveness of intervention programmes of institutionalized people from falling-research review. Kontakt (19)2: 105–115. DOI: 10.1016/j. kontakt.2017.04­.003.

8. Institute for Safe Medication Practices Canada (2015). Medication Incidents that Increase the Risk of Falls: A Multi-Incident Analysis. ISMP Canada Safety Bulletin (15)12.

9. Jurásková D (2007). Pracovní postup. Prevence pádů a zranění pacienta/klienta a jeho řešení. [Workflow. The prevention of patient’s/cli­ent’s falls and injuries and its solution]. Česká asociace sester. [online] [cit. 2018–10–23]. Available from: https://www.cnna.cz/…skoviny/cas_ pp_2007_0003.pdf

10. Lee DCA, Pritchard E, McDermott F (2014). Falls prevention education for older adults during and after hospitalization: a systematic review and meta-analysis. Health Educ J 73: 530–544. DOI: 10.1177/001789­6913499266.

11. Lindner E, Duftner Ch, Dejaco Ch, Schirmer M (2015). Risk factors for falls and their impact on the severity of fall-related injuries. Healthy Ageing Research 4: 33.

12. Majkusová K, Jarošová D (2014). Falls risk factors in an acute-care setting: a retrospective study. Cent Eur J Nurs Midw (5)2: 47–53.

13. Sahota O, Drummond A, Kendrick D, Grainge M J, Vas C, Sach T, et al. (2013). 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 Ageing 0: 1–6. DOI: 10.1093/agein­g/aft155.

14. Shorr RI, Chandler AM, Mion LC, Waters TM, Liu M, Daniels MJ, et al. (2012). Effects of an intervention to increase bed alarm use to prevent falls in hospitalized patients: a cluster randomized trial. Ann Inter Med 157: 692–699. DOI: 10.7326/0003–4819–157–10–201211200–00005.

15. Spiva L, Robertson B, Delk M, Patrick S, Kimrey M, Green B, Gallagher E (2014). Effectiveness of team training on fall prevention. J Nurs Care Qual (29)2: 164–173. DOI: 10.1097/NCQ.0b013e3182a­98247.

16. Toyabe S (2015). Characteristics of Inpatient Falls not Reported in an Incident Reporting System. G J Health Sci (8)3: 17–25. DOI: 10.5539/gjhs.v8n3p17.

17. Uríčková A, Schildová D, Ilievová L (2018). Fall-risk identification of geriatric patients in 2010–2014. Kontakt. 20(3): 223–229. DOI: 10.1016/j.kon­takt.2018.08.003.

18. Vlaeyen E, Coussement J, Leysens G, Van der Elst E, Delbaere K, Cambier D, et al. (2015). Characteristics and effectiveness of fall prevention programmes in nursing homes: a systematic review and meta-analysis of randomized controlled trials. J Am Geriatr Soc (63)2: 211–221. DOI: 10.1111/ jgs.13254.