Falls in a Psychiatric Unit

Abstract

Our study in a psychiatric ward of a general hospital aims to identify acutely ill psychiatric patients who are at high risk of falls. Patient falls were identified by data collectors after they were reported by hospital staff into the Fall Reporting Risk Management System (RMS). From 2007 to 2009, there were a total of 26 patients who fell in the psychiatric ward. Falls are likely to occur while the patient is ambulating beside the bed and is unlikely to be elimination-related. Slipping or tripping was the most common fall mechanism. There were no life-threatening injuries sustained and the most common type of injury was pain, swelling, contusions and abrasions. Two main patient profiles were identified to be at risk of falls, the first being elderly patients with mood disorders and co-morbid medical conditions such as diabetes. These patients are usually deemed high risk in the fall assessment. The second group of patients is young females with eating disorders and who are not on psychotropic medications. Both groups are likely to be alert and oriented, with no muscle weakness or a history of previous falls.

Factors associated with risk of falling among younger inpatients in a mental health setting—A systematic review

“…Besides the side effects of medication, it is likely that the psychiatric diagnosis could also result in changes of mental status leading to increasing risk of falls. This is supported in another cross‐sectional study which identified older patients with mood disorders, and younger female patients with eating disorders and not on psychotropic medications were at risk of falling (Meng et al, 2010). Moreover, both groups were also reported to be alert and orientated, and with no muscular weakness.…”

“…Further, most falls took place while the patients were walking next to the bed but these did not result in severe injuries. Mostly, the patients were alert alert, oriented, and did not exhibit muscle weakness or a prior history of falls (Meng et al, 2010).…”

“…The study also found that older mental health patients were more likely to fall due to decreased activities of daily living, while younger patients are susceptible to risk of falling due to side effects of medication affecting gait and mental status (Suga et al, 2021). However, Meng et al (2010) reported that young females with eating disorders faced a similar risk of falling, even if they were not taking psychotropic medications. Further, most falls took place while the patients were walking next to the bed but these did not result in severe injuries.…”