Reducing inpatient falls: Human Factors &amp; Ergonomics offers a novel solution by designing safety from the patients’ perspective

Hignett, Sue; Wolf, Laurie

doi:10.1016/j.ijnurstu.2016.02.007

Cited by 8 publications

(6 citation statements)

References 16 publications

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“…A balance between safe organizational processes, environment and equipment design, and task behaviors is needed (Hignett and Wolf, 2016). Indeed, due to the complexity of the health care organizational culture and the complexity of falls and their required prevention strategies, the whole system approach (including the patients' perspective) can deliver an understanding and improvement of safety integration .…”

Section: Discussionmentioning

confidence: 99%

Implementation of fall prevention in residential care facilities: A systematic review of barriers and facilitators

Vlaeyen

Stas

Leysens

et al. 2017

International Journal of Nursing Studies

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Objectives: To identify the barriers and facilitators for fall prevention implementation in residential care facilities. Design: Systematic review. Review registration number on PROSPERO: CRD42013004655. Data sources: Two independent reviewers systematically searched five databases (i.e. MEDLINE, EMBASE, CINAHL, PsycINFO, and Web of Science) and the reference lists of relevant articles. Review methods: This systematic review was conducted in line with the Center for Reviews and Dissemination Handbook and reported according to the PRISMA guideline. Only original research focusing on determinants of fall prevention implementation in residential care facilities was included. We used the Mixed Method Appraisal Tool for quality appraisal. Thematic analysis was performed for qualitative data; quantitative data were analyzed descriptively. To synthesize the results, we used the framework of Grol and colleagues that describes six healthcare levels wherein implementation barriers and facilitators can be identified. Results: We found eight relevant studies, identifying 44 determinants that influence implementation. Of these, 17 were facilitators and 27 were barriers. Results indicated that the social and organizational levels have the greatest number of influencing factors (9 and 14, respectively), whereas resident and economical/political levels have the least (3 and 4, respectively). The most cited facilitators were good communication and facility equipment availability, while staff feeling overwhelmed, helpless, frustrated and concerned about their ability to control fall management, staffing issues, limited knowledge and skills (i.e., general clinical skill deficiencies, poor fall management skills or lack of computer skills); and poor communication were the most cited barriers. Conclusion: Successful implementation of fall prevention depends on many factors across different healthcare levels. The focus of implementation interventions, however, should be on modifiable barriers and facilitators such as communication, knowledge, and skills. Effective fall prevention must consist of multifactorial interventions that target each resident's fall risk profile, and should be tailored to overcome context-specific barriers and put into action the identified facilitators.© 2017 Elsevier Ltd. All rights reserved.What is already known about the topic? Multifactorial interventions, tailored to each resident's fall risk profile, can reduce the number of falls and recurrent fallers under highly controlled circumstances, but seems to be ineffective under "real-world" conditions, presumably due to poor implementation.Successful implementation of complex, multifactorial interventions in clinical practice involves a tailored, multifaceted approach based on a good understanding of barriers and facilitators for implementation. No reviews exist that comprehensively summarize the evidence on fall prevention implementation barriers and facilitators in residential care settings. What this paper addsSeventeen facilitators and 27 barriers that ...

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Section: Discussionmentioning

confidence: 99%

Implementation of fall prevention in residential care facilities: A systematic review of barriers and facilitators

Vlaeyen

Stas

Leysens

et al. 2017

International Journal of Nursing Studies

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“…In the fall visits, it was found that ward staff could not promptly talk to these patients because there was no active intercom system linked to the isolation rooms. The staff had to spend time to put on personal protective equipment before entering the isolation rooms (work-as-done), which patients might have left their bed before the staff entered the isolation rooms 15. Therefore, the team liaised with the hospital facilities management unit to replace the intercom system to enhance the communication process.…”

Section: Lessons and Limitationsmentioning

confidence: 99%

“…It is not uncommon to see that these falls prevention interventions are implemented in a bundle in healthcare institutions since single intervention is not effective to prevent falls 4 13. Also, the interventions’ effectiveness is limited by the patients’ judgement and cooperation, the misalignment of their perception on the risk of fall and their worsening illnesses, as well as the latent systems factors including staffing, environment, equipment and workflow design 14 15. All these factors behind affect the effectiveness of falls prevention intervention resulting in falls remaining to be a difficult problem to treat.…”

Section: Introductionmentioning

confidence: 99%

Using human factors and ergonomics principles to prevent inpatient falls

Kwok¹,

Lam²

2022

BMJ Open Qual

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Inpatient falls are frequently reported incidents in hospitals around the world. The recent COVID-19 pandemic has further exacerbated the risk. With the rising importance of human factors and ergonomics (HF&E), a fall prevention programme was introduced by applying HF&E principles to reduce inpatient falls from a systems engineering perspective. The programme was conducted in an acute public hospital with around 750 inpatient beds in Hong Kong. A hospital falls review team (the team) was formed in June 2020 to plan and implement the programme. The ‘Define, Measure, Analyse, Improve and Control’ (DMAIC) method was adopted. Improvement actions following each fall review were implemented. Fall rates in the ‘pre-COVID-19’ period (January–December 2019), ‘COVID-19’ period (January–June 2020) and ‘programme’ period (July 2020–August 2021) were used for evaluation of the programme effectiveness. A total of 120, 85 and 142 inpatient falls in the ‘pre-COVID-19’, ‘COVID-19’ and ‘programme’ periods were reviewed, respectively. Thirteen areas with fall risks were identified by the team where improvement actions applying HF&E principles were implemented accordingly. The average fall rates were 0.476, 0.773 and 0.547 per 1000 patient bed days in these periods, respectively. The average fall rates were found to be significantly increased from the pre-COVID-19 to COVID-19 periods (mean difference=0.297 (95% CI 0.068 to 0.526), p=0.009), which demonstrated that the COVID-19 pandemic might have affected the hospitals fall rates, while a significant decrease was noted between the COVID-19 and programme periods (mean difference=−0.226 (95% CI −0.449 to –0.003), p=0.047), which proved that the programme in apply HF&E principles to prevent falls was effective. Since HF&E principles are universal, the programme can be generalised to other healthcare institutes, which the participation of staff trained in HF&E in the quality improvement team is vital to its success.

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“…In recent years, the number of slips and falls during walking or other movements among older people with sarcopenia has been increasing [1,2]. The U.S. Center for Disease Control and Prevention (CDC) [3] reported that the prevalence of falls associated with toilet use ranges from 19% to 37% in older persons.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Standing-Up Motion from a Forward-Sloping Toilet Seat for Older People

et al. 2021

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(1) Background: In-home assistive systems to help people with physical disabilities stand up from toilets are necessary, and the ease of the standing-up motion should be evaluated. (2) Methods: This study investigated the ease of the standing-up motion using objective and subjective data from healthy participants to facilitate the development of a toilet-seat-tilting system. Participants were divided into younger and older age groups. Objective data concerning muscle activity (EMG), three-dimensional (3D) body motion, and center of pressure distribution (COP) were collected. The participants also provided subjective data related to standing up from a toilet tilted at three different angles. (3) Results: All participants repeated the motion 25 times for each angle and provided feedback regarding their standing-up experience under each condition. Objective EMG, COP, and 3D body motion analysis results varied across individuals and age groups. The older group exhibited a consistent pattern of head motion while standing up. Thus, older individuals prefer a forward trunk-inclination motion. (4) Conclusions: According to the collected subjective data, all participants found it easier to stand when the seat angle was 5° or 10°; objective data on the ankle dorsiflexion angle, muscle activity, and head motion may be related to the subjective ease of the standing-up motion.

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Reducing inpatient falls: Human Factors & Ergonomics offers a novel solution by designing safety from the patients’ perspective

Cited by 8 publications

References 16 publications

Implementation of fall prevention in residential care facilities: A systematic review of barriers and facilitators

Implementation of fall prevention in residential care facilities: A systematic review of barriers and facilitators

Using human factors and ergonomics principles to prevent inpatient falls

Evaluation of Standing-Up Motion from a Forward-Sloping Toilet Seat for Older People

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