{"title":"Falls in an Australian Hospital During the COVID-19 Pandemic: A Study of Patient Safety Incident Reports.","authors":"Ritin Fernandez, Heidi Green, Olivia Paulik, Kate Christopher, Shona Haigh, Robyn Whitaker, Nqobile Sikhosana","doi":"10.1097/PTS.0000000000001336","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Inpatient falls pose a significant challenge in hospitals, impacting patient safety and resources. This retrospective study aimed to analyze the impact of the COVID-19 pandemic on fall incidents in a major metropolitan tertiary referral and teaching hospital in New South Wales (NSW), Australia.</p><p><strong>Methods: </strong>Utilizing clinical informatics, data from Clinical Health Information Exchange (CHIE) database, electronic medical records (eMR), and the NSW Health Incident Information Management System (IIMS)/Incident Management System Plus (IMS+) were collected. Inpatient falls reported at the study hospital between July and December 2019, 2020, and 2021 for patients aged 18 years and above were included. Extracted data encompassed patient demographics, medical history, fall characteristics, contributing factors, and fall incident harm scores. Descriptive and inferential statistics were undertaken using SPSS V 25, and inductive content analysis was used to analyze the narratives relating to the contributing factors for falls.</p><p><strong>Results: </strong>A total of 1399 inpatient falls were reported during the study period. Falls per 1000 occupied bed days (OBD) varied: 3.83 in 2019, 3.41 in 2020, and 4.35 in 2021. A significant increase in fall incidents was observed in 2021 compared to 2020. Most falls occurred on a weekday, particularly between 1400 and 2159 hours. Medicine departments reported the highest number of falls, followed by aged care units. Incident harm scores at level 3, indicating moderate injury, were prevalent across all 3 years. Contributing factors to falls according to the IIMS/IMS+ criteria were diverse, with \"Patient complexity/acuity,\" \"Patient engagement and compliance,\" \"Hazard/unsafe,\" and \"Clinical risk screening/assessment\" emerging prominently. In addition, 7 distinct themes contributing to inpatient falls were identified through inductive analysis.</p><p><strong>Conclusions: </strong>The study highlighted increased inpatient falls (4.35 falls per 1000 OBDs) during the July to December 2021 study period. Understanding fall patterns is vital for improving safety protocols. Emphasising incident reporting, staff training, environmental adjustments, and mobility-related risk management is crucial to reducing inpatient falls and fall-related injury during restricted visitor access during pandemics.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":"220-225"},"PeriodicalIF":1.7000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Patient Safety","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/PTS.0000000000001336","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/31 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Inpatient falls pose a significant challenge in hospitals, impacting patient safety and resources. This retrospective study aimed to analyze the impact of the COVID-19 pandemic on fall incidents in a major metropolitan tertiary referral and teaching hospital in New South Wales (NSW), Australia.
Methods: Utilizing clinical informatics, data from Clinical Health Information Exchange (CHIE) database, electronic medical records (eMR), and the NSW Health Incident Information Management System (IIMS)/Incident Management System Plus (IMS+) were collected. Inpatient falls reported at the study hospital between July and December 2019, 2020, and 2021 for patients aged 18 years and above were included. Extracted data encompassed patient demographics, medical history, fall characteristics, contributing factors, and fall incident harm scores. Descriptive and inferential statistics were undertaken using SPSS V 25, and inductive content analysis was used to analyze the narratives relating to the contributing factors for falls.
Results: A total of 1399 inpatient falls were reported during the study period. Falls per 1000 occupied bed days (OBD) varied: 3.83 in 2019, 3.41 in 2020, and 4.35 in 2021. A significant increase in fall incidents was observed in 2021 compared to 2020. Most falls occurred on a weekday, particularly between 1400 and 2159 hours. Medicine departments reported the highest number of falls, followed by aged care units. Incident harm scores at level 3, indicating moderate injury, were prevalent across all 3 years. Contributing factors to falls according to the IIMS/IMS+ criteria were diverse, with "Patient complexity/acuity," "Patient engagement and compliance," "Hazard/unsafe," and "Clinical risk screening/assessment" emerging prominently. In addition, 7 distinct themes contributing to inpatient falls were identified through inductive analysis.
Conclusions: The study highlighted increased inpatient falls (4.35 falls per 1000 OBDs) during the July to December 2021 study period. Understanding fall patterns is vital for improving safety protocols. Emphasising incident reporting, staff training, environmental adjustments, and mobility-related risk management is crucial to reducing inpatient falls and fall-related injury during restricted visitor access during pandemics.
目的:住院患者跌倒对医院构成重大挑战,影响患者安全和资源。本回顾性研究旨在分析2019冠状病毒病大流行对澳大利亚新南威尔士州(NSW)一家主要大都市三级转诊和教学医院跌倒事件的影响。方法:采用临床信息学方法,从临床健康信息交换(CHIE)数据库、电子病历(eMR)和NSW卫生事件信息管理系统(IIMS)/事件管理系统Plus (IMS+)中收集数据。纳入了2019年7月至12月、2020年和2021年18岁及以上患者在研究医院报告的住院跌倒。提取的数据包括患者人口统计、病史、跌倒特征、影响因素和跌倒事件伤害评分。使用SPSS V 25进行描述性和推理统计,并使用归纳内容分析来分析与跌倒相关因素的叙述。结果:研究期间共报告住院患者跌倒1399例。每1000个已占用床位日(OBD)的跌倒次数有所不同:2019年为3.83次,2020年为3.41次,2021年为4.35次。与2020年相比,2021年的跌倒事件显著增加。大多数下跌发生在工作日,特别是在1400至2159小时之间。医学部门报告的跌倒人数最多,其次是老年护理部门。事故伤害评分为3级,表明中度伤害,在所有3年中普遍存在。根据IIMS/IMS+标准,导致跌倒的因素多种多样,其中“患者复杂性/敏锐度”、“患者参与和依从性”、“危险/不安全”和“临床风险筛查/评估”出现突出。此外,通过归纳分析确定了导致住院患者跌倒的7个不同主题。结论:该研究强调,在2021年7月至12月的研究期间,住院患者跌倒率增加(每1000名obd中有4.35例跌倒)。了解跌倒模式对改进安全协议至关重要。强调事件报告、工作人员培训、环境调整和与行动有关的风险管理,对于在大流行期间限制访客进入期间减少住院患者跌倒和与跌倒有关的伤害至关重要。
期刊介绍:
Journal of Patient Safety (ISSN 1549-8417; online ISSN 1549-8425) is dedicated to presenting research advances and field applications in every area of patient safety. While Journal of Patient Safety has a research emphasis, it also publishes articles describing near-miss opportunities, system modifications that are barriers to error, and the impact of regulatory changes on healthcare delivery. This mix of research and real-world findings makes Journal of Patient Safety a valuable resource across the breadth of health professions and from bench to bedside.