Factors influencing patient falls in a private hospital group in the Cape Metropole of the Western Cape

Rensburg, Renee Janse van; Merwe, Anita van der; Crowley, Talitha

doi:10.4102/hsag.v25i0.1392

Cited by 7 publications

(4 citation statements)

References 15 publications

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“…The present study results showed that CABG patients with hypertension were more likely to fall. This finding is consistent with the results of Van Rensburg [23]. Khovasova's study showed that arterial hypertension could increase the risk of patients falling [11].…”

Section: Discussionsupporting

confidence: 92%

Risk of Falling after Coronary Artery Bypass Grafting Surgery And its Related Factors

Rajabi

Paryad

Khanghah

et al. 2022

J Holist Nurs Midwifery

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Introduction: A fall is a sudden descent on the ground or other lower levels. It is a serious safety threat for hospitalized patients. Coronary artery bypass graft (CABG) surgery as an open heart surgery has complications such as cardiac arrhythmias and delirium that can increase the risk of fall. Objective: This study aims to determine the risk of falls in patients after CABG surgery and investigate its associated factors. Matetials and Methods: This cross-sectional study was conducted on 302 patients undergoing CABG surgery in a specialized hospital in Rasht City, Iran, from November 2019 to July 2020. They were selected by a sequential sampling method. The data collection instrument included demographic information, disease-related factors, surgery-related factors (before, during, after), and the Morse fall scale (MFS) checklist. The study data were collected after the patient's surgery and transfer from the intensive care unit to the surgical ward. Descriptive statistics, as well as the Kolmogorov Smirnov, Wilcoxon, Mann-Whitney U, Kruskal-Wallis, and Spearman correlation, were used to analyze the collected data. A rank regression model was used to determine the factors related to the risk of falls in patients. Results: The mean ±SD age of participants was 59.35 ±8.37 years. About 70.53% of the patients were male, and 46.03% were overweight (Body Mass Index ranged 25-29.9 kg/m2). The majority of patients at the time of admission to the surgical ward and before surgery (92.72%) had no risk of falls. After surgery and transfer to the surgical ward, 82.12% had a low risk of falls. The mean risk of falling was higher in patients over 60 years (P <0.05). With decreasing hemoglobin values on the morning of surgery, the risk of postoperative fall increased (P = 0.046, r = -0.115). The sodium level on the morning of surgery had a significant negative correlation (P = 0.040, r = -0.118) with the risk of falling, but urea level on the morning of surgery had a significant positive correlation (P = 0.001, r = 0.212) with the risk of falling. Using regression model, the results showed that with increasing age (B = 0.23, 95%CI; 0.07-0.39, P = 0.003), history of high blood pressure (B= 3.5, 95%CI: -0.69-0.39, P = 0.003), decrease in hemoglobin (B = -5.47, 95%CI; -10.2- -0.6, P = 0.02), an increase in creatinine (B = 17.73, 95%CI; 8.17-27.29, P = 0.001) and urea (B = 6.09, 95%CI; 2.57-9.61, P = 0.001) before the surgery, the risk of fall after CABG surgery increases. Conclusion: Several factors can increase the risk of falls after CABG surgery. Considering that the risk of falls in patients undergoing CABG surgery in most medical centers is examined only at the beginning of admission, it is recommended to consider the possibility of postoperative falls based on the predicting variables.

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Section: Discussionsupporting

confidence: 92%

Risk of Falling after Coronary Artery Bypass Grafting Surgery And its Related Factors

Rajabi

Paryad

Khanghah

et al. 2022

J Holist Nurs Midwifery

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“…An accurate and quick fall risk screening tool in identifying patients at high risk of falling in the hospital is the most important step in preventing falls and avoiding their consequences. The lack of accurate and consistent patient falls risk assessments, the risk of more severe falls increased [ 18 ]. Therefore, the purpose of this study was to revise the original tool in order to create a more accurate inpatient fall risk screening tool.…”

Section: Introductionmentioning

confidence: 99%

The Fall Risk Screening Scale Is Suitable for Evaluating Adult Patient Fall

Chen

Shen

et al. 2022

Healthcare

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(1) Background: This study aimed to test the feasibility of utilizing the screening tool for fall risk assessment in adult inpatient and verify its accuracy in a medical center in Taiwan. (2) Methods: This study retrospectively collected all adult fall cases among inpatients occurring in the general wards of a medical center between 1 January 2013 and 31 December 2015. This inpatient fall risk screening scale was measured by the sensitivity, specificity, and accuracy. (3) Results: There were 1331 (0.4%) falls among a total of 357,395 inpatients during this period. Factors predictive of falling risk included: age, consciousness, body shift assistance, use of fall risk medications, fall history, dizziness or weakness, toileting, and impaired mobility. Using the eight-factor assessment, two was the best cutoff point for identifying the fall risk group, with area under Receiver Operating Characteristic (ROC) curve (AUC) = 0.817, sensitivity = 80.93%, specificity = 73.0%, accuracy = 73.03%, and likelihood ratio = 11.48. (4) Conclusions: The accuracy of the eight-item fall risk assessment tool created for this study was validated. These results can serve as a reference for institutions to develop more effective fall risk assessment scale for inpatients, enabling clinical nurses to identify and more comprehensively assess the groups at highest risk for falling during their hospital stay.

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“…Instead, they suggested that the bed should be reduced to the ground height when the patient is lying in bed. Rensburg et al [ 42 ] also showed that inappropriate use of bed rails contributed to moderate and major fall-related injuries. Their results differed from those presented here, which suggests that more studies need to be conducted to confirm the role of bed rails in preventing fall-related injuries.…”

Section: Discussionmentioning

confidence: 99%

Incidence and clinical characteristics of fall-related injuries among older inpatients at a tertiary grade a hospital in Shandong province from 2018 to 2020

et al. 2022

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Background Falls are an important cause of injury and death of older people. Hence, analyzing the multifactorial risk of falls from past cases to develop multifactorial intervention programs is clinically significant. However, due to the small sample size, there are few studies on fall risk analysis of clinical characteristics of fallers, especially among older hospitalized patients. Methods We collected data on 153 inpatients who fell (age ≥ 60 years) from the hospital nursing adverse event reporting system during hospitalization at Shandong Provincial Hospital Affiliated to Shandong First Medical University, China, from January 2018 to December 2020. Patient characteristics at the time of the fall, surrounding environment, primary nurse, and adverse fall events were assessed. The enumeration data were expressed as frequency and percentage, and the chi-squared was performed between recurrent fallers and single fallers, and non-injurious and injurious fall groups. Results Cross-sectional data showed 18.3% of the 153 participants experienced an injurious fall. Compared with single fallers, a large proportion of older recurrent fallers more often experienced preexisting conditions such as cerebrovascular disease or taking hypoglycemic drugs. They were exposed to higher risks and could experience at least 3 fall times in 3 months. Besides, the credentials of their responsible nurses were often higher. Factors that increased the risk of a fall-related injury were hypoglycemic drugs (OR 2.751; 95% CI 1.114–6.795), and nursing adverse events (OR 47.571; 95% CI 14.392–157.247). Older inpatients with bed rails (OR 0.437; 95% CI 0.190–1.005) or falling at the edge of the bed (OR 0.365; 95% CI 0.138–0.964) were less likely to be injured than those without bed rails or not falling at the edge of the bed. Fall risks were significantly correlated with more severe fall-related injuries. Older patients with moderate (OR 5.517; CI 0.687–44.306) or high risk (OR 2.196; CI 0.251–19.219) were more likely to experience fall-related injuries than those with low risk. Conclusions Older inpatient falls are an ongoing challenge in hospitals in China. Our study found that the incidence of fall-related injuries among inpatients aged ≥ 60 years remained at a minor level. However, complex patient characteristics and circumstances can contribute to fall-related injuries. This study provides new evidence on fall-related injuries of older inpatients in China. Based on the factors found in this study, regular fall-related injury epidemiological surveys that investigate the reasons associated with the injuries were crucial when considering intervention measures that could refine fall-related injuries. More prospective studies should be conducted with improved and updated multidisciplinary fall risk assessment and comprehensive geriatric assessment as part of a fall-related injury prevention protocol.

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Factors influencing patient falls in a private hospital group in the Cape Metropole of the Western Cape

Cited by 7 publications

References 15 publications

Risk of Falling after Coronary Artery Bypass Grafting Surgery And its Related Factors

Risk of Falling after Coronary Artery Bypass Grafting Surgery And its Related Factors

The Fall Risk Screening Scale Is Suitable for Evaluating Adult Patient Fall

Incidence and clinical characteristics of fall-related injuries among older inpatients at a tertiary grade a hospital in Shandong province from 2018 to 2020

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