An Analysis of 277 Falls in Hospital

Fine, Wilfred

doi:10.1159/000244584

Cited by 31 publications

(14 citation statements)

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“…Most of the published studies have tended to concentrate on nocturia in men, because of the perceived association between nocturia and BOO [3,4], although women also experience nocturia [5]. Nocturia becomes increasingly common with increasing age in both men and women [5][6][7], and is associated with considerable morbidity in relation to its association with falls in the elderly secondary to night-time toiletting [8,9]. Nocturia also has a negative effect on a woman's sense of well-being because of sleep disturbance [10] and is a troublesome symptom, with 63% of women who void at least twice a night finding this a problem [7].…”

Section: Introductionmentioning

confidence: 99%

Nocturnal polyuria in community‐dwelling women

2004

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OBJECTIVETo determine the age prevalence of nocturnal polyuria among older women in the community, and to investigate the relationship between nocturnal polyuria and nocturia. PATIENTS AND METHODSIn all, 1183 women aged ≥50 years, who were registered with a family doctor practice and who had taken part in a prevalence study, were sent brief questionnaires and a frequency/volume chart (FVC) to complete. RESULTSThere were 227 FVCs with adequate data and 264 completed questionnaires available for analysis. The prevalence of nocturnal polyuria increased disproportionately with age. There was no clear relationship between nocturia or nocturnal polyuria and daytime frequency, nor was there a clear relationship between diuretic use and nocturnal polyuria. CONCLUSIONNocturnal polyuria is common among women in the community and not obviously related to daytime frequency. Night-time symptoms are common in women as well as men, and are troublesome to them.

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Section: Introductionmentioning

confidence: 99%

Nocturnal polyuria in community‐dwelling women

2004

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“…Other studies have been made on the morbidity of hospitalized geriatric patients 21 . In 1952, Fine reported data on 277 consecutive falls in a British geriatric ward.…”

Section: Review Of the Literaturementioning

confidence: 99%

Falls among the Elderly

Perry

1982

J American Geriatrics Society

143

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This paper summarizes the medical literature relevant to falls sustained by the elderly to highlight what is known about the magnitude of the problem, to identify those aged at risk, and to ascertain the risk factors for falling. While searching for general trends in the literature, the analysis concentrates on several characteristics of such studies, including the study populations, the measurement of risk factors, the measurement of outcome, and the systematic biases involved. Possible mechanisms are suggested for use of the profound influence of pre-existing disease in the elderly as a predictor of falling and subsequent injury. On the basis of this analysis of the literature, suggestions are made about avenues for future research that would answer more definitively the questions remaining about falls among the elderly.

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“…Environmental lighting at night has long been suspected to exert an important influence on the risk of falls among older hospital patients [32] and the prevalence of visual impairment in people aged over 60 [33] is one of the central issues. Age-related deterioration in the visual system is most usually manifested as a loss of visual acuity; however, problems such as reduction in the visual field, lowered sensitivity to luminance contrast, and increased sensitivity to glare are not uncommon [34].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of a stepped wedge cluster RCT and concurrent observational sub-study to evaluate the effects of modified ward night lighting on inpatient fall rates and sleep quality: a protocol for a pilot trial

Chari

Smith

Mudge

et al. 2016

Pilot Feasibility Stud

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BackgroundFalls among hospitalised patients impose a considerable burden on health systems globally and prevention is a priority. Some patient-level interventions have been effective in reducing falls, but others have not. An alternative and promising approach to reducing inpatient falls is through the modification of the hospital physical environment and the night lighting of hospital wards is a leading candidate for investigation. In this pilot trial, we will determine the feasibility of conducting a main trial to evaluate the effects of modified night lighting on inpatient ward level fall rates. We will test also the feasibility of collecting novel forms of patient level data through a concurrent observational sub-study.Methods/designA stepped wedge, cluster randomised controlled trial will be conducted in six inpatient wards over 14 months in a metropolitan teaching hospital in Brisbane (Australia). The intervention will consist of supplementary night lighting installed across all patient rooms within study wards. The planned placement of luminaires, configurations and spectral characteristics are based on prior published research and pre-trial testing and modification. We will collect data on rates of falls on study wards (falls per 1000 patient days), the proportion of patients who fall once or more, and average length of stay. We will recruit two patients per ward per month to a concurrent observational sub-study aimed at understanding potential impacts on a range of patient sleep and mobility behaviour. The effect on the environment will be monitored with sensors to detect variation in light levels and night-time room activity. We will also collect data on possible patient-level confounders including demographics, pre-admission sleep quality, reported vision, hearing impairment and functional status.DiscussionThis pragmatic pilot trial will assess the feasibility of conducting a main trial to investigate the effects of modified night lighting on inpatient fall rates using several new methods previously untested in the context of environmental modifications and patient safety. Pilot data collected through both parts of the trial will be utilised to inform sample size calculations, trial design and final data collection methods for a subsequent main trial.Trial registrationAustralian New Zealand Clinical Trials Register (ANZCTR): ACTRN12614000615684 (cluster RCT) and ACTRN12614000616673 (observational sub-study).Date Registered: 10 June 2014 (both studies).Protocol version: 1.2 (Dated: 01 June 2014)Anticipated completion: September 2015Role of Trial Sponsor: The named sponsor for this investigator-initiated trial was the Director of the Royal Brisbane and Women’s Hospital (RBWH) Safety and Quality Unit (Therese Lee, Phone: +61 7 3646 8111). The principal investigators, SC and MA, are employed by the RBWH Safety and Quality Unit. The trial sponsor has no involvement in any aspects of study design, conduct or decision to submit the report for publication. AM and MD are employed by other departments in the sam...

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An Analysis of 277 Falls in Hospital

Cited by 31 publications

References 0 publications

Nocturnal polyuria in community‐dwelling women

Nocturnal polyuria in community‐dwelling women

Falls among the Elderly

Feasibility of a stepped wedge cluster RCT and concurrent observational sub-study to evaluate the effects of modified ward night lighting on inpatient fall rates and sleep quality: a protocol for a pilot trial

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