{"title":"Multifactorial fall interventions for people over 65 years in the acute hospital setting: pre-post-test design.","authors":"Allison Wallis, Christina Aggar, Deb Massey","doi":"10.1080/10376178.2024.2420088","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Falls are the most reported patient safety incident for patients >65 years in acute hospital settings worldwide. While multifactorial fall interventions reduce the number of falls in subacute and rehabilitation settings, fall interventions in acute hospital settings are unknown.</p><p><strong>Aim: </strong>To evaluate the effectiveness of multifactorial fall interventions on the number of falls using codesigned education targeting staff and the patient and review the environment in acute hospital settings in NSW, Australia for patients over 65 years of age.</p><p><strong>Method: </strong>A pre-post-test design with a non-equivalent group was conducted. All acute hospital inpatient falls occurring both pre- and post-intervention within one health district were included in this study. The use of Quality Improvement methodology identified gaps in risk screening and assessment, education and information, communication of risk, and standardised fall prevention equipment. Codesigned interventions to address these gaps were undertaken.</p><p><strong>Results: </strong>The number of falls (<i>p</i> = 0.038) and injurious falls (<i>p</i> < 0.001) significantly decreased in the post-intervention group. There was a significant improvement in fall assessments (<i>p</i> < 0.001), delirium risk screening (<i>p</i> < 0.001), the provision of fall information (<i>p</i> < 0.001) and fall risk discussed at shift handover (<i>p</i> < 0.001) in the post-intervention group. Following the intervention, staff were significantly more likely to undertake fall education modules (<i>p</i> < 0.001) and develop a fall management plan (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Falls continue to have a significant economic impact on the acute hospital setting. Our findings highlight multifactorial fall interventions that included staff and patients in the development phases reduced the number of falls. Multifactorial fall interventions targeting staff, patients and the environment may influence a reduction in the number of falls and the severity of falls in the acute hospital setting.</p><p><strong>Impact statement: </strong>Multifactorial fall interventions reduce injurious falls, minor injuries, and falls resulting in serious injury and death.</p>","PeriodicalId":93954,"journal":{"name":"Contemporary nurse","volume":" ","pages":"1-13"},"PeriodicalIF":0.0000,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Contemporary nurse","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/10376178.2024.2420088","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Falls are the most reported patient safety incident for patients >65 years in acute hospital settings worldwide. While multifactorial fall interventions reduce the number of falls in subacute and rehabilitation settings, fall interventions in acute hospital settings are unknown.
Aim: To evaluate the effectiveness of multifactorial fall interventions on the number of falls using codesigned education targeting staff and the patient and review the environment in acute hospital settings in NSW, Australia for patients over 65 years of age.
Method: A pre-post-test design with a non-equivalent group was conducted. All acute hospital inpatient falls occurring both pre- and post-intervention within one health district were included in this study. The use of Quality Improvement methodology identified gaps in risk screening and assessment, education and information, communication of risk, and standardised fall prevention equipment. Codesigned interventions to address these gaps were undertaken.
Results: The number of falls (p = 0.038) and injurious falls (p < 0.001) significantly decreased in the post-intervention group. There was a significant improvement in fall assessments (p < 0.001), delirium risk screening (p < 0.001), the provision of fall information (p < 0.001) and fall risk discussed at shift handover (p < 0.001) in the post-intervention group. Following the intervention, staff were significantly more likely to undertake fall education modules (p < 0.001) and develop a fall management plan (p < 0.001).
Conclusion: Falls continue to have a significant economic impact on the acute hospital setting. Our findings highlight multifactorial fall interventions that included staff and patients in the development phases reduced the number of falls. Multifactorial fall interventions targeting staff, patients and the environment may influence a reduction in the number of falls and the severity of falls in the acute hospital setting.
Impact statement: Multifactorial fall interventions reduce injurious falls, minor injuries, and falls resulting in serious injury and death.
背景:跌倒是全球急症医院65岁以上患者中报告最多的患者安全事故。目的:在澳大利亚新南威尔士州的急症医院中,对 65 岁以上的患者进行针对员工和患者的编码设计教育,并对环境进行审查,以评估多因素跌倒干预措施对跌倒数量的影响:方法:对非等效组进行前测后测设计。在一个卫生区内,干预前后发生的所有急症医院住院病人跌倒事件均被纳入本研究。通过使用质量改进方法,确定了在风险筛查和评估、教育和信息、风险沟通以及标准化防跌倒设备方面存在的差距。为弥补这些不足,我们采取了编码设计干预措施:结果:跌倒次数(p = 0.038)和伤害性跌倒(p p p p p p p 结论:跌倒继续对急症医院的经济产生重大影响。我们的研究结果表明,将员工和患者纳入开发阶段的多因素跌倒干预措施可减少跌倒次数。针对员工、患者和环境的多因素跌倒干预措施可能会减少急症医院环境中的跌倒次数并降低跌倒的严重程度。