Impact of Nurses’ Intervention in the Prevention of Falls in Hospitalized Patients

Abstract

Background: Clinical safety is a crucial component of healthcare quality, focused on identifying and avoiding the risks to which patients are exposed. Among the adverse events that occur in a hospital environment, falls have a large impact (1.9–10% of annual income in acute care hospitals); they can cause pain, damage, costs, and mistrust in the health system. Our objective was to assess the effect of an educational intervention aimed at hospital nurses (systematic assessment of the risk of falls) in reducing the incidence of falls. Methods: this was a quasi-experimental study based on a sample of 581 patients in a third level hospital (Comunitat Valenciana, Spain). An educational program was given to the intervention group (n = 303), and a control group was included for comparison (n = 278). In the intervention group, the nurses participated in a training activity on the systematized assessment of the risk of falls. Analysis was undertaken using the Bayesian logistic regression model. Results: a total of 581 patients were studied (50.6% male, 49.4% female), with an average age of 68.3 (DT = 9) years. The overall incidence of falls was 1.2% (0.3% in the intervention group and 2.2% in the control group). Most of the falls occurred in people ≥65 years old (85.7%). The intervention group had a lower probability of falling than the control group (OR: 0.127; IC95%: 0.013–0.821). Neither the length of hospital stay, nor the age of the participants, had any relevant effect. Conclusions: the systematic assessment of the risk of a patient falling during hospital processes is an effective intervention to reduce the incidence of falls.

Interventions to reduce falls in hospitals: a systematic review and meta-analysis

“…Montejano-Lozoya et al. [ 67 ] assessed the effect of an educational intervention for hospital nurses. There was a higher incidence of falls in the control group compared with the intervention group although the sample size was comparatively low.…”

“…Fifteen of the included studies in the systematic review had a non-randomised design [ 36 , 37 , 39 , 41 , 42 , 51 , 54 , 58 , 60–62 , 64 , 65 , 67 , 69 ]. Supplementary Table 3 shows that many of these scored well on method quality [ 36 , 37 , 39 , 41 , 42 , 51 , 58 , 60–62 , 65 , 69 ].…”

“…Supplementary Table 3 shows that many of these scored well on method quality [ 36 , 37 , 39 , 41 , 42 , 51 , 58 , 60–62 , 65 , 69 ]. Three had a medium risk of bias; one associated with the statistical analysis, differences in participants in control and experimental groups and a lack of multiple measurements [ 54 ] another due to differences in participants, lack of follow-up and statistical analysis [ 64 ] and one had differences in participants in the control and experimental groups, uncertainty regarding multiple measurements, and unclear reporting of follow up measures [ 67 ]. The studies on divesting from scored FRAT screening both had a low risk of bias ( Supplementary Table 6 ).…”

Falls as the result of interplay between nurses, patient and the environment: Using text-mining to uncover how and why falls happen

“…Nurses are in the best position to identify how and why falls happen since the majority of falls occur during patients’ daily activities, which nurses are responsible for assisting with [ 24 ]. Studies show that more than half of falls happen in patients’ rooms, followed by bathrooms and shower rooms [ 6 ], and 60.9% of falls are attributable to nursing care [ 1 ].…”

Association Between Falling and Activities of Daily Living Measured by the Longshi Scale in Patients Poststroke

“…Fall risk evaluation is very important for patients who have suffered a stroke. Nurses, who are responsible for the evaluation of patients on admission, are the ideal professional to identify patients at risk for falls and implement related prevention strategies 39. Several scales have been used to assess fall risk in different settings, such as Morse Fall Scale, Downton Fall Risk Index, and Hendrich Fall Risk Assessment 40.…”