Do portable nursing stations within bays of hospital wards reduce the rate of inpatient falls? An interrupted time-series analysis

Abstract

Backgroundfalls can negatively affect patients, resulting in loss of independence and functional decline and have substantial healthcare costs. Hospitals are a high-risk falls environment and regularly introduce, but seldom evaluate, policies to reduce inpatient falls. This study evaluated whether introducing portable nursing stations in ward bays to maximise nurse–patient contact time reduced inpatient falls.Methodsinpatient falls data from local hospital incident reporting software (Datix) were collected monthly (April 2014–December 2017) from 17 wards in Stoke Mandeville and Wycombe General Hospitals, the UK. Portable nursing stations were introduced in bays on these wards from April 2016. We used a natural experimental study design and interrupted time series analysis to evaluate changes in fall rates, measured by the monthly rate of falls per 1000 occupied bed days (OBDs).Resultsthe wards reported 2875 falls (April 2014–December 2017). The fallers’ mean age was 78 (SD = 13) and 58% (1624/2817) were men. Most falls, 99.41% (2858/2875), resulted in none, low or moderate harm, 0.45% (13/2875) in severe harm and 0.14% (4/2875) in death. The monthly falls rate increased by 0.119 per 1000 OBDs (95% CI: 0.045, 0.194; P = 0.002) before April 2016, then decreased by 0.222 per 1000 OBDs (95% CI: −0.350, −0.093; P = 0.001) until December 2017. At 12 months post-intervention, the absolute difference between the estimated post-intervention trend and pre-intervention projected estimate was 2.84 falls per 1000 OBDs, a relative reduction of 26.71%.Conclusionportable nursing stations were associated with lower monthly falls rates and could reduce inpatient falls across the NHS.

<p>Bed Moves, Ward Environment, Staff Perspectives and Falls for Older People with High Falls Risk in an Acute Hospital: A Mixed Methods Study</p>

“…The built environment is a core aspect of patient safety, falls risk, 8,20 and potentially also may influence positively or negatively the need for bed moves. Changes to ward layout or practice that can accommodate increased visibility for patients with high falls risk, for example, through decentralized nursing or portable nursing stations, 36 may reduce risk of falls, and the need for bed moves. The use of acuity adaptable rooms that provide a greater flexibility for managing complex and changing patient needs within a single location has been shown in a pre-post design study to reduce bed moves, medication errors and falls, as well as other organisational, staff and patient benefits.…”

Portable nursing stations reduce the rate of inpatient falls in UK hospitals

“…The purpose of this study4 was to determine the effect of PNSs on the rate of inpatient falls. It is an experimental study and interrupted time series analysis.…”

“…Healthcare expenditures as direct and indirect payment of injurious falls in the UK are calculated at over £2 billion per year, mostly related to hip fracture 3. Therefore, reducing falls is a key organisational priority that leads to better patient safety 1–4. A recent suggestion in tackling falls reduction is the use of PNSs 4…”

“…Therefore, reducing falls is a key organisational priority that leads to better patient safety 1–4. A recent suggestion in tackling falls reduction is the use of PNSs 4…”

Research Progress on Risk Factors and Prevention Strategies of Falls in Elderly Inpatients

“…When the nurse is working on a portable workstation, keep the door of the ward open as much as possible for observation. Nurses are encouraged to work in SITB as much as possible, rather than doing routine work in a large nursing station [12].…”