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The prevention of falls in hospital

The prevention of falls in hospital
The prevention of falls in hospital

Falls occurring as a presenting feature of acute medical illness are significantly associated with a prolonged hospital stay, discharge to a residential or nursing home and death. An epidemiological study of falls on acute medical wards revealed a faller rate of 3.5% of patients admitted and that ward differences exist in fall numbers and demographics. A case controlled study of patient characteristics and a subsequent study of fall characteristics suggested that ward environment and design might predispose to falls on the ward and affect fall demographics. A series of studies to validate a fall risk score was carried out to help identify patients at risk of falls on the wards. The risk scores studied were the Downtown, Tinetti and STRATIFY risk scores. All of the scores were very sensitive but not very specific. The Downton score was chosen for further use as it had the highest total predictive accuracy. The concluding Hospital Injury Prevention (HIP) study was aimed to determine whether multidisciplinary intervention could reduce falls and injury in hospital. 825 patients were admitted on three wards. Patients' fall risk was assessed weekly and an individually tailored fall prevention programme was discussed. In this randomised study a multidisciplinary approach to risk factor identification and intervention led to a 29.7% reduction in the number of fallers and a 51.1% reduction of patients sustaining an injury. There was a marginal reduction in the number of falls. The characteristics of patients falling repeatedly and patients falling within the first week were studied further by analysing the collected data. Confusion, unsafe gait and antidepressant use were associated with recurrent falls. Confusion, an unsafe gait and a past history of falls were associated with early falls.

This series of studies have explored various aspects of falls occurring within a hospital environment. Findings from these studies may be useful in implementing fall prevention measures in hospital and may help stimulate further research on the topic.

University of Southampton
Vassallo, Michael
15d899f4-f6a5-42d7-8093-bd2c4565b561
Vassallo, Michael
15d899f4-f6a5-42d7-8093-bd2c4565b561

Vassallo, Michael (2002) The prevention of falls in hospital. University of Southampton, Doctoral Thesis.

Record type: Thesis (Doctoral)

Abstract

Falls occurring as a presenting feature of acute medical illness are significantly associated with a prolonged hospital stay, discharge to a residential or nursing home and death. An epidemiological study of falls on acute medical wards revealed a faller rate of 3.5% of patients admitted and that ward differences exist in fall numbers and demographics. A case controlled study of patient characteristics and a subsequent study of fall characteristics suggested that ward environment and design might predispose to falls on the ward and affect fall demographics. A series of studies to validate a fall risk score was carried out to help identify patients at risk of falls on the wards. The risk scores studied were the Downtown, Tinetti and STRATIFY risk scores. All of the scores were very sensitive but not very specific. The Downton score was chosen for further use as it had the highest total predictive accuracy. The concluding Hospital Injury Prevention (HIP) study was aimed to determine whether multidisciplinary intervention could reduce falls and injury in hospital. 825 patients were admitted on three wards. Patients' fall risk was assessed weekly and an individually tailored fall prevention programme was discussed. In this randomised study a multidisciplinary approach to risk factor identification and intervention led to a 29.7% reduction in the number of fallers and a 51.1% reduction of patients sustaining an injury. There was a marginal reduction in the number of falls. The characteristics of patients falling repeatedly and patients falling within the first week were studied further by analysing the collected data. Confusion, unsafe gait and antidepressant use were associated with recurrent falls. Confusion, an unsafe gait and a past history of falls were associated with early falls.

This series of studies have explored various aspects of falls occurring within a hospital environment. Findings from these studies may be useful in implementing fall prevention measures in hospital and may help stimulate further research on the topic.

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Published date: 2002

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Local EPrints ID: 464845
URI: http://eprints.soton.ac.uk/id/eprint/464845
PURE UUID: 3928f993-138b-4f85-ada2-e798dadea9c9

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Date deposited: 05 Jul 2022 00:04
Last modified: 05 Jul 2022 00:04

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Author: Michael Vassallo

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