Targeting Environmental Factors to Reduce Elderly In-Patient Falls

Hignett, Sue; Sands, Gina; Youde, Jane; Griffiths, Paula

doi:10.1201/ebk1439834978-c11

Cited by 7 publications

(7 citation statements)

References 27 publications

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“…Hitcho et al ( 2004 ) reported that a high percentage of falls ( n = 155; 84.7%) occurred in the patients’ rooms, while 20 (10.9%) happened in the bathroom and eight (4.4%) in other areas. Hignett et al ( 2010 ) found in their study that the majority of falls happened at the bed of the patient and the second highest area of falls was in the bathroom. This corresponds with the results of the present study.…”

Section: Discussionmentioning

confidence: 97%

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

Rensburg

Merwe

Crowley

2020

Health SA Gesondheid

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Background: The fall rate of patients in hospitals is a worldwide concern due to the impact falls have on patients, the family or relatives, as well as the healthcare setting. Factors influencing patient falls are categorised as intrinsic and extrinsic. Intrinsic factors refers to physical conditions and the extrinsic factors include the environment of the patient, nursing staffing levels and skill mix.Aim: The study aimed to determine the factors that influence patient falls.Setting: A private hospital group in the Cape Metropole of the Western Cape.Methods: A quantitative retrospective descriptive research approach was used by analysing 134 records of patients that have fallen from October 2016 to February 2018. Data was collected using a data extraction sheet and analysed using the Statistical Package for the Social Sciences (SPSS).Results: Intrinsic factors contributing to patient falls includedthe patient’s age, hypertension, co-morbidities and the use of benzodiazepines as a sedative. Extrinsic factors were the incorrect use of bed rails and the skill mix of the staff. In over half of the cases (n = 68; 50.7%), risk assessments were not performed according to the protocol. Only 5 (3.7%) patients sustained major injuries due to the falls. However, the risk of more severe falls increased 2.4 times with the lack of risk assessment.Conclusion: The lack of accurate and consistent patient fall risk assessments, use of benzodiazepines as a sedative and the staff skill mix were contributors to the fall rate in these hospitals.

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Section: Discussionmentioning

confidence: 97%

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

Rensburg

Merwe

Crowley

2020

Health SA Gesondheid

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“…A review of national incident reports in England and Wales (2006-07) found different risk factors for patients with strength and mobility problems (frail) and those with cognitive impairment (confused). Although most patients fell by the bedside, significantly fewer than expected frail patients fell by the bedside and a significantly higher than expected number of frail patients and lower than expected number of confused patients fell in the bathroom (Hignett et al, 2010). Disorientation has been identified as a contributory factor in both the falls and dementia environmental design literatures (Chaâbane, 2007;Morse et al, 1987;Namazi & Johnson, 1991b;Torrington, 2006).…”

Section: Discussionmentioning

confidence: 99%

“…To explore the use of design in these interventions, Figure 1 offers a summary of the sequential Masud, 2006, andHignett et al, 2010. steps for fall management: assessment, communication, monitoring, modifying the patient, and modifying the environment. These strategies will be discussed in detail in the following sections.…”

Section: Introductionmentioning

confidence: 99%

Technology and Building Design: Initiatives to Reduce Inpatient Falls among the Elderly

Hignett

2010

HERD

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This paper offers a narrative exploration of interventions for inpatient falls among the elderly with respect to the design of technology (equipment and furniture) and buildings. Most of the contributory risk factors for inpatient falls among the elderly were identified in the 1950s, but incident and injury rates remain relatively unchanged in the 2000s. Interventions have predominantly focused on staff and organizational changes, for example monitoring (observation) and communication, possibly in response to increased patient privacy (isolation) in single rooms. The clinical response has been to modify the patient by means of medication review, continence management, and impact protectors. This paper considers whether technology and building design have helped or hindered the newly admitted frail and/or confused elderly patient at risk of falling, assuming the provision of good nursing and medical practice (e.g., observation, treatment, and care).

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“…Donius and Rader (1994) suggested that the use of bedrails may increase the distance of falls from the bed whereas Hignett et al (2010) found the reverse in a small pilot study, where patient falls with raised rails were clustered at the foot end of the bed.…”

Section: Figure 1 Control Panel Handset and Bed Rail Hand Setmentioning

confidence: 99%

Conflicting Benefits and Hazards of Hospital-Style Bed Rails

Hignett¹

2010

Advances in Human Factors and Ergonomics Series

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• This is a conference paper. ABSTRACTThis paper reviews the design and use of hospital-style bed rails. Rails were originally used as a safety feature for psychiatric patients at risk of falling in the 1800s. There are benefits, for example security in transit, facilitating repositioning, but also hazards, including deaths and injuries associated with entrapment. The developments in the technological specification of hospital beds (electric) has increased with their functionality. However, a survey in England and Wales found that patients on electric beds / pressure mattresses were three times more likely to have their rails raised. This may lead to an increase in the exposure to the risks associated with bed rails and presents a conflict for designers, staff and patients.

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Targeting Environmental Factors to Reduce Elderly In-Patient Falls

Cited by 7 publications

References 27 publications

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

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

Technology and Building Design: Initiatives to Reduce Inpatient Falls among the Elderly

Conflicting Benefits and Hazards of Hospital-Style Bed Rails

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