Prioritising patients for hospital occupational therapy to reduce inpatient falls: A retrospective case-control study to identify predictive patient falls risk factors

Abstract

Introduction: Prompt identification of patients susceptible to falls is required by occupational therapists to initiate early falls prevention and management strategies. This study identified the intrinsic and extrinsic risk factors of patients who experience early inpatient falls (within 48 hours of admission). Method: A retrospective case-control study was completed at a tertiary hospital. Data were extracted from medical records. Adults aged 18 years and older, admitted with any diagnosis, to any ward within the hospital between July 2019 and June 2020 were included. Cases were identified as those who fell within 48 hours of admission and controls did not experience a fall. Results: The study sample included 218 patients (109 cases and 109 control patients). Most falls occurred in the patient’s room ( n = 54) or bathroom ( n = 47), as a result of slipping ( n = 50) or while patients were toileting ( n = 32). Multivariate regression analysis identified significant predictors of inpatient falls, including unassisted mobilisation (odds ratio (OR) 5.25), impaired balance (OR 7.25), reduced muscle strength (OR 5.25) and impulsivity (OR 19.57). Receiving occupational therapy reduced risk of falling by 81%. Conclusion: Falls risk factors that are predictive of early inpatient falls should be identified at admission and used to prioritise patients for occupational therapy.