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Citation
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Francis-Coad J, Hill AM, Jacques A, Chandler AM, Richey PA, Mion LC, Shorr RI. J. Gerontol. A Biol. Sci. Med. Sci. 2020; ePub(ePub): ePub. |
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Affiliation
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Department of Epidemiology, University of Florida, Gainesville, Florida, USA. |
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Abstract
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BACKGROUND: Hospital falls remain common and approximately 30% of falls in hospital result in injury. The aims of the study were to; i) identify the association between fall interventions present at the time of the injurious fall and injurious faller characteristics; ii) identify the association between fall preventive interventions present at the time of the injurious fall and the injurious fall circumstances.
METHODS: Secondary data analysis of de-identified case series of injurious falls across 24 acute medical/surgical units in the US. Variables of interest were falls prevention interventions (physical therapy, bed alarm, physical restraint, room change or a sitter) in place at the time of fall. Data were analyzed using logistic regression and hazard ratios.
RESULTS: There were 1033 patients with an injurious fall, occurrence peaked between day one and day four, with 46.8% of injurious falls having occurred by day three of admission. Injurious fallers with a recorded mental state change 24 hours prior to the fall were more likely to have a bed alarm provided (adjusted OR 2.56, 95% CI 1.61, 4.08) and receive a physical restraint as fall prevention interventions (adjusted OR 6.36, 95% CI 4.35, 9.30). Injurious fallers restrained fell later (stay day six) than those without a restraint (stay day four) (p=0.007) and had significantly longer lengths of stay (13 days versus nine days).
CONCLUSIONS: On medical/surgical units, injurious falls occur early following admission suggesting interventions should be commenced immediately. Injurious fallers who had a physical restraint as an intervention had longer lengths of stay.
© The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Language: en |