Author:
López-Soto Pablo Jesús,Rodríguez-Cortés Francisco José,Miñarro-Del Moral Rosa María,Medina-Valverde María José,Segura-Ruiz Rocío,Hidalgo-Lopezosa Pedro,Manfredini Roberto,Rodríguez-Borrego María Aurora,Ramírez-Pérez María Ángeles,de la O Granados-Roldán Maria,Márquez-Cuenca Francisco Javier,Garrido-Ramiro María Dolores,Vicente-Fenoy Celia,de la Cruz López-Carrasco Juan,
Abstract
Abstract
Background
Falls are among the most common and serious adverse events for hospitalised patients. In-hospital falls pose a major medical and economic challenge for public health worldwide. Nevertheless, the issue is often addressed without regard to certain relevant variables such as the time of the fall. The aim of this study was to determine the effect of the implementation of a nurse-led intervention based on the temporal patterns of falls and their aetiology on the occurrence of falls.
Methods
A mixed-method research design was carried out in three phases: a) a longitudinal prospective study (audits, chronobiological analyses and implementation of a multicentre nurse-led intervention based on temporal patterns of falls); b) a retrospective study of fall records; and c) a qualitative study based on focus groups. The protocol was published in 2021.
Results
A difference was observed in the number of fall records before and after the chronopreventive intervention (retrospective: 64.4% vs. 35.6%; p < 0,001). According to the interrupted series analysis, considering the influence of the COVID-19 pandemic, a reduction in falls of 2.96% (95% CI 1.70%-4.17%) was observed. The concepts of falls, the COVID-19 pandemic and the causes of non-registration have emerged as categories for qualitative analysis.
Conclusions
A multicentric nurse-led program based on tailored organisational, educational and behavioural chronopreventive measures seems to lead to a reduction in the number of in-hospital falls. The findings of the present study, highlighting the implementation of chronopreventive measures, can serve as a basis for future health policies.
Trial registration
The project was registered on the Clinical Trials Registry NCT04367298 (29/04/2020).
Funder
Consejería de Salud y Familias, Junta de Andalucía
Publisher
Springer Science and Business Media LLC
Reference39 articles.
1. Alves RA, LombardiJunior I, Agner VFC. Level of physical activity and risk of falls in the institutionalized elderly. J Phys Res. 2018;8(4):518–27. https://doi.org/10.17267/2238-2704rpf.v8i4.2168.
2. Roudsari BS, Ebel BE, Corso PS, Molinari NA, Koepsell TD. The acute medical care costs of fall-related injuries among the U.S. older adults. Injury. 2005;36:1316–22.
3. Chang JT, Ganz DA. Quality indicators for falls and mobility problems in vulnerable elders. J Am Geriatr. 2013;55(2):S327–34.
4. World Health Organization (WHO). WHO global report on falls prevention in older age. Geneva: World Health Organization; 2007.
5. Deandrea S, Bravi F, Turati F, Lucenteforte E, La Vecchia C, Negri E. Risk factors for falls in older people in nursing homes and hospitals. A systematic review and meta-analysis. Arch Gerontol Geriatr. 2013;56:407–15.