Seasonal ambient changes influence inpatient falls

Magota, Chie; Sawatari, Hiroyuki; Ando, Shin-ichi; Nishizaka, Mari K.; Tanaka, Kaoru; Horikoshi, K.; Hoashi, Izumi; Hashiguchi, Nobuko; Ohkusa, Toshifumi; Chishaki, Akiko

doi:10.1093/ageing/afw254

Cited by 11 publications

(17 citation statements)

References 10 publications

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“…Data on this temporal association are few and limited to falls, regardless of timing, in community-dwelling elderly women, which failed to demonstrate a strong association with LUTS 49 and to falls where a relationship to toileting in hospital inpatients has been demonstrated. [50][51][52] Likewise, there are no clinical trials that have addressed the impact of any nocturia intervention with falls or falls risk as a primary outcome. The relatively low absolute incidence of falls, even in a population at risk, makes this a daunting task.…”

Section: Falls and Fracturesmentioning

confidence: 99%

Nocturia: A Highly Prevalent Disorder With Multifaceted Consequences

Bliwise

Wagg

Sand

2019

Urology

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Section: Falls and Fracturesmentioning

confidence: 99%

Nocturia: A Highly Prevalent Disorder With Multifaceted Consequences

Bliwise

Wagg

Sand

2019

Urology

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“…Previous research has shown that insufficient lighting is a relevant risk factor for falls [3][4][5]. Similarly, Magota et al [6] found that the majority of falls in a hospital set-DOI: 10.1159/000504883 ting occurs during the night. As vision significantly contributes to posture control and navigation, adequate lighting is of importance especially to older persons with peripheral sensory impairments [7][8][9].…”

Section: Introductionmentioning

confidence: 96%

“…Ambulation towards the bathroom seems to be the nightly task causing the greatest fall risk. Research focusing on hospital incident reports noted that the majority of falls were related to toileting [6]. Similarly, nocturia has been identified as a risk factor for falls [10].…”

Section: Introductionmentioning

confidence: 99%

A Guiding Nightlight Decreases Fear of Falling and Increases Sleep Quality of Community-Dwelling Older People: A Quantitative and Qualitative Evaluation

Thölking

Lamers²,

Rikkert

2020

Gerontology

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Background: Even though poor lighting at nighttime is an important risk factor for falls (and most falls occur during the night), lighting interventions to improve nightly lighting from bed to bathroom are rarely evaluated for fall prevention. Objective: We tested the hypothesis that an automated guiding light would reduce nightly fear of falling (FOF) and increase sleep quality of community-dwelling older people. Methods: This study had a pragmatic uncontrolled beforeafter design, including participants during a period of 8 months if they (i) were aged at least 65 years, (ii) ambulated independently at night, and (iii) had no cognitive or audiovisual impairments obstructing outcome measurement. Automated LED strips (Gight TM ) were installed in the participants' homes. The primary outcome measure was overnight FOF on a scale of 0-10. Secondary outcome measures included sleep quality on a scale of 0-10 and fall rate. Additionally, a sample of participants was interviewed about their experiences with Gight. Results: Sixty-four participants were included (mean age: 80.8 ± 8.1 years; 89% living independently). Mean study length was 118 days (range: 30-231). In the intention-to-treat analysis, overnight FOF declined from 5.5 ± 3.0 to 3.8 ± 3.2 (p = 0.001), and sleep quality increased from 6.7 ± 2.4 to 7.4 ± 1.7 (p = 0.012). The fall rate during the study was too low to detect changes. Participants appreciated Gight (8.4 ± 0.8 on a scale of 10), and the majority (57%) reported a subjective decrease in FOF. Conclusion: Gight shows promising results for overnight FOF and sleep quality, but the effect of lighting interventions on fall rate should be evaluated further before widespread implementation.

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“…[5][6][7] For patients with possible head injury from a fall, computed tomography (CT) is often ordered, but its utility following fall in hospitalized patients has not been outlined. 1,2 Inpatient falls are distinct from those in other settings, as patients who fall in the hospital have different risk factors than those in the community, including but not limited to high-risk medications, advanced age, and delirium. In addition, they typically lack other risk factors that are seen in the emergency department, such as blunt trauma.…”

Section: Introductionmentioning

confidence: 99%

“…Inpatient falls are a major patient safety concern in all health-care facilities and one of the principal iatrogenic adverse events reported in hospitals. 1 A fall incidence of up to 9 falls per 1000 bed-days has been reported, which represents approximately 1 million inpatient falls annually in the United States. 2 Inpatient falls have been shown to substantially increase morbidity, length of stay, and cost.…”

Section: Introductionmentioning

confidence: 99%

The Applicability of New Orleans Criteria for Head Computed Tomography in Inpatient Falls With Injury

Yarlagadda

Joshi

Cerasale

et al. 2019

The Neurohospitalist

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Background: Inpatient falls are a patient safety concern. Limited data exist on the utility of head computed tomography (CT) for inpatient falls. The New Orleans Criteria (NOC) is a validated tool to determine the appropriateness of neuroimaging in the emergency department for falls with minor head injury. This study aimed to evaluate whether the NOC could be applied to inpatient falls. Methods: This retrospective cohort study assessed 1 year of inpatient falls with injury at 5 inpatient facilities. Records were reviewed for demographic data, fall circumstances, laboratory results, components of the NOC, and head CT results. Cohorts included positive NOC (≥1 NOC finding) and negative NOC. Sensitivity and specificity were calculated for the NOC alone, NOC plus coagulopathy, and NOC or coagulopathy for acute intracranial process. Results: Of 332 inpatient falls with injury, 188 (57%) received a head CT. Of the 250 (75.3%) NOC-positive cases, 159 (63.6%) received a head CT. Of all patients who received a head CT, 7 (2.1%) showed a significant acute intracranial process. The NOC was positive in 6 of the 7 cases (sensitivity 85.7% and specificity 23.8%); the other case had a significant coagulopathy. New Orleans Criteria or coagulopathy had 100% sensitivity and 23.4% specificity. Conclusions: Our findings show that use of the NOC to evaluate potential intracranial injury in inpatient falls is limited. Adding criteria to the NOC may improve its test characteristics, with a sensitivity of 100% for the NOC or coagulopathy, suggesting potential clinical utility.

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Seasonal ambient changes influence inpatient falls

Abstract: N/A (Because of retrospective nature).

Cited by 11 publications

References 10 publications

Nocturia: A Highly Prevalent Disorder With Multifaceted Consequences

Nocturia: A Highly Prevalent Disorder With Multifaceted Consequences

A Guiding Nightlight Decreases Fear of Falling and Increases Sleep Quality of Community-Dwelling Older People: A Quantitative and Qualitative Evaluation

The Applicability of New Orleans Criteria for Head Computed Tomography in Inpatient Falls With Injury

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