Falls on an inpatient rehabilitation spinal injuries unit: the characteristics, circumstances, and consequences

Abstract

Study design Retrospective audit Objectives To describe the nature of falls and fallers in a spinal injuries unit (SIU) and identify factors associated with having more than one fall (recurrent fallers) and falls with physical or psychological consequences (consequential falls). Setting An Australian inpatient rehabilitation SIU. Methods Data were retrospectively extracted from falls incident reports and electronic medical records over a 5-year period. Data were analysed descriptively to summarise participant and fall details. Univariate analyses identified candidate variables for further investigation in a multivariate model for recurrent fallers and consequential falls. Results Of the 566 persons admitted to the SIU, 132 (23%) participants experienced 207 falls over the 5 years. Of the fallers, 41 (31%) were recurrent fallers experiencing between 2 and 7 falls and 78 (59%) experienced a consequential fall. No significant variables were identified for recurrent fallers. For consequential falls, older age (OR = 1.038, 95% CI, 1.012 to 1.064, p = 0.004) and female gender (OR = 3.581, 95% CI, 1.269 to 10.103, p = 0.016) were significant, as well as falls that occurred on a Sunday (OR = 0.196, 95% CI, 0.061 to 0.630, p = 0.006). Falls while transferring were less likely to be consequential (OR = 4.100, 95% CI, 1.706 to 9.856, p = 0.002). Conclusions Nearly one quarter of SIU inpatients experienced a fall with almost a third of those who fell experiencing recurrent falls. Older age, female gender, and Sundays were risk factors for falls with consequence.

Developing a fall prevention program in an inpatient spinal cord injury rehabilitation unit: A participatory action research study

“…Since SCI is a permanent disability, it is crucial to address fall prevention early during inpatient admissions reported fall rates for inpatient SCI in neurorehabilitation wards can be as high as 24%, emphasizing the importance of implementing fall prevention measures during inpatient rehabilitation. Understanding the dynamics of falls during this stage of recovery is essential [ 4 ].…”

“…Individuals who experience falls may develop a condition known as "post-fall syndrome," marked by a fear of falling, reduced physical activity and independence [ 7 ], decreased involvement in rehabilitation programs [ 5 ], prolonged treatment duration and hospital stay, ultimately disrupting rehabilitation goals [ 8 ]. Therefore, fall prevention should be integrated throughout the entire inpatient admission process [ 4 ].…”

“…Understanding the unique circumstances surrounding falls during SCI rehabilitation can facilitate the development of targeted and individualized fall prevention programs early in the rehabilitation process [ 4 ]. Action research stands out as one of the most effective research methods for addressing issues within care settings.…”