Background: Fall prevention strategies are developed to prevent falls in the general patient population. Stroke patients, however, present with unique deficits that increase their potential for falls. There is strong evidence that creating a better understanding of the factors contributing to post stroke falls, and pairing stroke specific interventions with current fall prevention strategies, will result in improved patient safety. Purpose: The primary Objective of this study was to identify the unique characteristics of stroke patients that place them at higher risk for falls, and develop strategies and practices that reflect awareness of stroke deficits. The secondary Objective of this study was to demonstrate the feasibility of preventing harm through reducing the opportunity for injury. Methods: This study reviewed 174 falls occurring from 2015 to 2018 in an Inpatient Rehabilitation unit (IRU) and an Ortho/Neuro unit. The data was obtained through post fall huddle reports which include: diagnosis, gender, stroke location, circumstances precipitating the fall, National Institute of Stroke Scales (NIHSS), and timing of fall. Results: Of 174 falls on the IRU and Ortho/Neuro units, 51% [88/174] of the patients had a stroke diagnosis, 49% [85/174] were identified as “other”. Exclusion of “other” diagnosis resulted in a sample size of 88 patients, comprised of 44% female and 56% male. Of the patients included, 10% had bilateral infarcts, 41% right brain, and 43% left brain infarcts. The circumstances precipitating falls included: 22% during transfers, 32% during toileting, and 36% from falling out of bed/chair, or were unattended. NIHSS and timing of fall were not found to be statistically significant in this study. Conclusion: Identification of a stroke patient’s potential for falling, and development of prevention strategies, may increase the safety on the unit. In addition to current fall prevention strategies, stroke patients should have toileting and purposefully rounding plans developed prior to the start of shift, with an emphasis on transferring and toileting assistance needs. These plans should be shared during shift huddles and bedside report. Due to the relatively small sample size, further studies would be benefited by a larger sample group.
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