Predictors of Serious Fall Injury in Hospitalized Patients

Anderson, Chrys; Dolansky, Mary A.; Damato, Elizabeth G.; Jones, Katherine R.

doi:10.1177/1054773814530758

Cited by 19 publications

(21 citation statements)

References 28 publications

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“…In 2009, the American Centre for Disease Control reported that the incidence of fall and fall-related injuries for males and the elderly above 85 years of age was four times greater than the patients aged 65-74. 21,22 In the DUNLOP study, conditions associated with age such as arthritis, diabetes, heart disease, urinary incontinence, and visual impairment were suggested as predictors of the increased risk of falling among patients. 23 In the study of Quigley et al, 24 there has been a positive correlation between age increase and fall-induced injuries among hospitalized patients.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Falls in Hospital In-Patients: A Prospective Nested Case Control Study

Najafpour

Godarzi

Arab

et al. 2019

Int J Health Policy Manag

107

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Background: Patient falls are considered a challenge to the patient’s safety in hospitals, which, in addition to increasing the length of stay and costs, may also result in severe injuries or even the death of the patient. This study aims to investigate the associations between risk factors among fallers in comparison with the control group. Methods: A prospective nested case control study was performed on 185 patients who fell and 1141 controls were matched with the patients at risk of fall in the same ward and during the same time. This study was conducted in a university educational hospital in Tehran with 800 beds during a 9-month period. The data included demographics, comorbidities, admission details, types of medication, clinical conditions, and activities before or during the fall. The data was collected from clinical records, hospital information system, error reporting system and observations, and the interviews with the fallers, their families and care givers (physicians, nurses, etc). Data analysis was conducted through time-based matching using a multi-level analysis. Results: In a multilevel model including patient-related, medication, and care-related variables, the factors that were significantly associated with an increased risk of patient falls included: longer length of stay (odds ratio [OR] = 1.01; CI=0.32 to 0.73), using chemotherapy drugs, sedatives, anticonvulsants, benzodiazepines, and angiotensin-converting enzyme (ACE) inhibitors, visual acuity (OR=6.93; CI=4.22 to 11.38), balance condition (OR= 6.41; CI=4.51 to 9.11), manual transfer aid (OR=8.47; CI=5.65 to 12.69), urinary incontinence (OR= 8.47, CI= 5.65 to 12.69), and cancer (OR=2.86, CI=1.84-4.44). These factors were found to be associating with more odds for a falling accident among patients. Several characteristics such as fall history (OR=0.48; CI= 1.003 to 1.02), poly-pharmacy (OR=1.37, CI=00.85 to 2.2), stroke (OR=0.94, CI= 0.44 to 2.02), and nurse to patient ratio (incidence rate ratio=1.01, CI=0.01 to 0.03) were not significantly associated with falling in hospitals. Conclusion: It seems that a combination of both patient-related factors and history of medication should be considered. Moreover, modifiable clinical characteristics of patients such as vision improvement, provision of manual transfer aid, diabetes control, regular toilet program, and drug modification should be considered during the formulation of interventions.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Falls in Hospital In-Patients: A Prospective Nested Case Control Study

Najafpour

Godarzi

Arab

et al. 2019

Int J Health Policy Manag

107

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“…A PFH helps to evaluate and improve clinical practice, including unanticipated changes, such as regular quality improvement meetings for falls prevention. Fall prevention programs can be based on data from the post-fall assessment as evidenced by Anderson et al (2015) in which a post-assessment led to the creation of agency-level fall policies that addressed patient confusion and ways to prevent related falls.…”

Section: Discussionmentioning

confidence: 99%

“…To continually assess the contextual elements of falls, we examined relevant items on the PFH form. Similar tools to the PFH form, that incorporate multiple etiologies for falls, have been found to have a 70% sensitivity for predicting falls (Anderson et al, 2015). To our knowledge, there is not a validated tool to address prevention of recurrent falls available but what has been recommended is using a tool that covers intrinsic and extrinsic risk assessment to reduce falls.…”

Section: Methodsmentioning

confidence: 99%

Improving falls in nursing homes: a post-fall huddle quality improvement project

Buckner

Sherry

2019

IJANS

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Falls are one of the most common preventable health problems in adults 65 years and older (AHRQ, 2013). A fall in this population can have a devastating effect often leading to a significant change in morbidity or death. Adults in assisting living, nursing homes, and skilled facilities (SNF) have an increased risk of falling and having a subsequent fall due to an acute illness, weakness, or confusion. This makes individualizing a plan of care to prevent a secondary fall and identifying the root cause of falls within a facility imperative.In our agency, the fall rate is nearly triple that of the national benchmark. To address this problem, a Post-Fall Huddle project was implemented. The literature recommends and supports the practice of a post-fall assessment program in fall reduction to identify intrinsic and extrinsic fall risk etiologies. There was found to be a reduction in the absolute values of recurrent patient falls per quarterly reporting after the implementation of the post-fall huddle. The results also provided pertinent data that can be used for recommendations in future fall prevention for the SNF

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“…Falls are described as any sudden, unexpected and unintentional occurrence resulting in a patient landing on the ground or at lower level [ 1 ]. Prevention of patient falls is an important aspect of patient safety management, particularly in elderly patients who often present impaired balance and who are at higher risk of fracture [ 2 ]. In patients ≥65 years old, at least one fall will occur within a year in about 30% of community dwellers and in 50% of patients in nursing homes [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Reliability and Validity of the Hendrich II Fall Risk Model in a Chinese Hospital Population

Zhang

Lin

et al. 2015

PLoS ONE

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To translate, validate and examine the reliability and validity of a Chinese version of the Hendrich II Fall risk Model (HFRM) in predicting falls in elderly inpatient. A sample of 989 Chinese elderly inpatients was recruited upon admission at the Peking Union Medical College Hospital. The inpatients were assessed for fall risk using the Chinese version of the HFRM at admission. The reliability of the Chinese version of the HFRM was determined using the internal consistency and test-rested methods. Validity was determined using construct validity and convergent validity. Receiver operating characteristic (ROC) curves were created to determine the sensitivity and specificity. The Chinese version of the HFRM showed excellent repeatability with an intra-class correlation coefficient (ICC) of 0.9950 (95% confidence interval (CI): 0.9923–0.9984). The inter-rater reliability was high with an ICC of 0.9950 (95%CI: 0.9923–0.9984). Cronbach’s alpha coefficient was 0.366. Content validity was excellent, with a content validity ratio of 0.9333. The Chinese version of the HFRM had a sensitivity of 72% and a specificity of 69% when using a cut-off of 5 points on the scale. The area under the curve (AUC) was 0.815 (P<0.001). The Chinese version of the HFRM showed good reliability and validity in assessing the risk of fall in Chinese elderly inpatients.

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Predictors of Serious Fall Injury in Hospitalized Patients

Cited by 19 publications

References 28 publications

Risk Factors for Falls in Hospital In-Patients: A Prospective Nested Case Control Study

Risk Factors for Falls in Hospital In-Patients: A Prospective Nested Case Control Study

Improving falls in nursing homes: a post-fall huddle quality improvement project

Evaluation of Reliability and Validity of the Hendrich II Fall Risk Model in a Chinese Hospital Population

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