Using human factors and ergonomics principles to prevent inpatient falls

Abstract

Inpatient falls are frequently reported incidents in hospitals around the world. The recent COVID-19 pandemic has further exacerbated the risk. With the rising importance of human factors and ergonomics (HF&E), a fall prevention programme was introduced by applying HF&E principles to reduce inpatient falls from a systems engineering perspective. The programme was conducted in an acute public hospital with around 750 inpatient beds in Hong Kong. A hospital falls review team (the team) was formed in June 2020 to plan and implement the programme. The ‘Define, Measure, Analyse, Improve and Control’ (DMAIC) method was adopted. Improvement actions following each fall review were implemented. Fall rates in the ‘pre-COVID-19’ period (January–December 2019), ‘COVID-19’ period (January–June 2020) and ‘programme’ period (July 2020–August 2021) were used for evaluation of the programme effectiveness. A total of 120, 85 and 142 inpatient falls in the ‘pre-COVID-19’, ‘COVID-19’ and ‘programme’ periods were reviewed, respectively. Thirteen areas with fall risks were identified by the team where improvement actions applying HF&E principles were implemented accordingly. The average fall rates were 0.476, 0.773 and 0.547 per 1000 patient bed days in these periods, respectively. The average fall rates were found to be significantly increased from the pre-COVID-19 to COVID-19 periods (mean difference=0.297 (95% CI 0.068 to 0.526), p=0.009), which demonstrated that the COVID-19 pandemic might have affected the hospitals fall rates, while a significant decrease was noted between the COVID-19 and programme periods (mean difference=−0.226 (95% CI −0.449 to –0.003), p=0.047), which proved that the programme in apply HF&E principles to prevent falls was effective. Since HF&E principles are universal, the programme can be generalised to other healthcare institutes, which the participation of staff trained in HF&E in the quality improvement team is vital to its success.

Nurses’ Experience Implementing an Automated Video Monitoring System to Decrease the Risk of Patient Falls during a Global Pandemic

“…This finding is surprising since multiple studies have reported an increase in the risk of inpatient falls during the COVID-19 pandemic. This heightened risk was due to patient factors such as an increased prevalence of comorbidities [ 17 ] and system factors such as nursing staff shortages [ 18 ] and delayed response time to meet patient needs as nursing staff donned personal protective equipment before entering a room [ 17 ].…”

Interventions to Improve Patient Safety During the Covid-19 Pandemic: A Systematic Review

“…Both studies on falls prevention discussed different triaging and modified procedures such as ICU reorganization 59 . Another study discussed the use of team communication and collaboration to identify patients at increased risk 62 .…”

“…One novel study used WhatsApp as a digital platform to improve communication 13 . For pressure injury and falls there was research on creating new teams to improve communication 57,62 . Medication safety interventions most often emphasized teamwork and communication, primarily using pharmacy teams.…”

Application of Ergonomics in Product Design Based on Computer-Aided Design

“…Taking ergonomics as a consideration, the industrial product operating device fully demonstrates the added value beyond the product's own function, and in terms of the product's own added value, it mainly reflects fairness and convenience. Among industrial products, there are some products with complex operability that better meet the requirements of humanized product design, and such products are more competitive; that is, they are more suitable for the needs of the market environment [8]. For example, there are too many complex operations in agricultural machinery and equipment.…”