Incidência de quedas e ações preventivas em um Hospital Universitário

Abstract

Objective Describing the incidence of falls and its relation with preventive actions developed in a Brazilian university hospital. Method A retrospective longitudinal study. Hospitalized adult patients in the clinical, surgical, psychiatric and emergency units who suffered a fall in the institution, and who had the event notified in the period from January 2011 to December 2015 were included in the study. The data were collected from the institution's management information system and analyzed in the SPSS statistical program. Results There were 2,296 falls, with a mean incidence of 1.70 falls/1,000 patients per day. An increase in the incidence of falls was observed in the period from 2011 (1.61) to 2012 (2.03). In the following years, the incidence of falls decreased from 1.83 falls/1,000 patients per day in 2013 to 1.42 falls/1,000 patients per day in 2015. The incidence of falls accompanied an implementation of preventive actions, suggesting the impact of such interventions in reducing the event occurrence. Conclusion The findings demonstrate the importance of implementing preventive interventions in reducing the incidence of falls in hospitalized patients.

Características das quedas com dano em pacientes hospitalizados

“…In the present study, 43% of the total number of events were damaged, being mostly mild (80%), followed by severe (11.9%) and moderate (7.3%). The rate of damage due to falls found in other investigations carried out in the context of hospital admission was 26 to 38.6% (5)(6)8,(13)(14)17) .…”

“…The falls do not occur uniformly in the hospital environment and depend on the patient profile, the characteristics of the unit, the processes and practices adopted, being more prevalent in units with greater numbers of elderly people, in specific areas such as neurology and rehabilitation, or in those with lower nursing personnel size (8,(18)(19) .…”

“…The main problem related to falls is the occurrence of damage to the patient, which occurs in approximately 30 to 50% of the cases including bruises, bruises, bruises, femoral fractures, hip and skull trauma, and can lead the patient to death in the most severe (2,4,7) Damaged falls can worsen patients' clinical condition, cause physical limitations and disabilities, increase length of stay, hospital costs, and ethical and legal issues for the institution. The consequences of these events are not only physical, but also psychological and social, especially in the elderly, such as the fear of falling again, loss of confidence in the ability to walk safely, depression, higher rates of hospital readmission and discharge to homes geriatric (2,4,(7)(8) .…”

Preventing falls in hospitalized elderly: design and validation of a team intervention

“…The care provided and their efforts in this regard must ensure the safety and well-being of the elderly (20) . The safety of the environment must be guaranteed for all patients, regardless of risk, since hospitals represent an unknown and unfamiliar environment, and are more critical for the elderly (23) . Policies and (legislation) must allow the detection of poor practices and deal with situations where safety may be compromised (20) .…”

Burnout and its interface with patient safety

“…It was found that lower incidence of falls resulted from the implementation of preventive measures, suggesting that the prevention protocol, the use of a risk assessment scale, the systematic raising of awareness and guidance to patients, family members and the nursing staff may have impacted the occurrence of the event in the institution. 31 It should be emphasized that all measures to prevent medication errors and falls are relevant. However, what this review adds is that due to the association of these types of incidents with the dimensions of Burnout, it is also necessary to improve the health of the workers, especially in relation to emotional exhaustion and depersonalization.…”