Risk factors for fall occurrence in hospitalized adult patients: a case-control study

Abstract

Objective:to identify risk factors for falls in hospitalized adult patients. Methods:a matched case-control study (one control for each case). A quantitative study conducted in clinical and surgical units of a teaching hospital in Southern Brazil. The sample comprised 358 patients. Data were collected over 18 months between 2013-2014. Data analysis was performed with descriptive statistics and conditional logistic regression using Microsoft Excel and SPSS version 18.0. Results:risk factors identified were: disorientation/confusion [OR 4.25 (1.99 to 9.08), p<0.001]; frequent urination [OR 4.50 (1.86 to 10.87), p=0.001]; walking limitation [OR 4.34 (2.05 to 9.14), p<0.001]; absence of caregiver [OR 0.37 (0.22 to 0.63), p<0.001]; postoperative period [OR 0.50 (0.26 to 0.94), p=0.03]; and number of medications administered within 72 hours prior the fall [OR 1.20 (1.04 to 1.39) p=0.01]. Conclusion:risk for falls is multifactorial. However, understanding these factors provides support to clinical decision-making and positively influences patient safety.

A predictive model for fall risk in hospitalized adults: A case–control study

“…The study variables were predefined according to criteria of clinical and epidemiological relevance found in a previous integrative review of the literature (Severo et al., ). Conceptual and operational definitions were made for each variable of interest and were presented in a previous study on fall risk factors (Severo, Kuchenbecker, Vieira, Lucena, & Almeida, ): age, sex (male, female and transgender), length of hospital stay, time of fall, place of fall, number of patients per nurse, lack of caregivers at the time of the fall, lack of nursing fall risk diagnosis, lack of a fall risk wristband at the time of the fall, a fall in the previous 3 months due to physiological causes, fear of falling, disorientation and/or confusion, agitation, walking limitations, Timed Up and Go Test (Podsiadlo & Richardson, ), morbidities, postoperative status (in the current hospitalization), change in visual acuity, admitted from the intensive care unit (ICU), change in urinary (frequent urination) and intestinal (diarrhea) eliminations and number and type of medications (benzodiazepines, opioids, barbiturates, antipsychotics, antidepressants, antihypertensives, laxatives, diuretics, antihistamines, sedatives and anticonvulsants).…”

Correspondence of nurses' and physiotherapists' records for orthopedic patients with the Nursing Outcomes Classification

“…The Morse Scale, used at the study site, is a scale for assessing the risk of falls and is composed of six assessment criteria: falls history, secondary diagnosis, ambulatory aid, intravenous therapy, gait, and mental status. According to the total score, patients are classified as with high, medium or low risk of falling (16) . This verification aims to improve patient safety, as well as to qualify systematized Nursing care, with a focus on preventing falls and the resulting harms.…”

Análise da concordância entre prontuário eletrônico e notificações no registro de quedas: estudo de coorte

“…A monitorização dos incidentes é importante para a garantia da segurança dos pacientes e depende de esforços para que a identificação seja feita antes que causem dano. Os riscos devem ser identificados a tempo de implementar melhorias que evitem o resultado negativo, e este processo deve ser contínuo, visto que os riscos são inerentes (Severo et al, 2018). Ainda, para a enfermagem, especificamente, a identificação de fatores de risco de quedas permite implementar o Processo de Enfermagem a partir do Diagnóstico de Enfermagem "Risco de Quedas", planejar, implementar e avaliar o cuidado de enfermagem em sua magnitude, garantindo a prevenção desse incidente e a segurança do paciente.…”