Toronto Rehabilitation Institute-University Health Network, 520 Sutherland Dr, Toronto, ON, M4G 3V9, Canada.
Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.
BMC Health Serv Res. 2020 Apr 15;20(1):299. doi: 10.1186/s12913-020-05168-8.
Preventing patient falls is a priority in tertiary spinal cord injury (SCI) rehabilitation. Falls can result in patient or staff injury, delayed rehabilitation, and hospital liability. A comprehensive overview of fall prevention/management policies and procedures in Canadian SCI rehabilitation is currently lacking. We describe and compare the fall prevention/management policies and procedures implemented in Canadian tertiary hospitals that provide SCI rehabilitation.
Fall prevention/management documents implemented in SCI rehabilitation at six Canadian tertiary rehabilitation hospitals across five provinces were analyzed using a document analysis. Analysis involved multiple readings of the documents followed by a content and thematic document analysis.
Fall prevention/management policies and procedures in SCI rehabilitation were organized into three main categories: 1) pre-fall policies and procedures; 2) post-fall policies and procedures; and, 3) communication between and amongst staff, patients, and families. Pre-fall policies and procedures encompassed: a) the definition of a fall; b) fall risk assessments in SCI rehabilitation; and, c) fall prevention strategies. The post-fall policies and procedures included: a) recovery from a fall; b) incident reporting process; and, c) fall classification. Components of fall prevention/management policies and practices that differed between hospitals included the fall risk assessments, post-fall huddles, and fall classifications.
Fall prevention/management is a required organizational practice for all hospitals. Although Canadian tertiary hospitals that provide SCI rehabilitation have similar components of fall prevention/management policies and procedures, the specific requirements differ at each site. There is a need for evidence-informed, consensus-driven implementation of SCI-specific fall prevention and management procedures across Canadian SCI rehabilitation settings.
预防患者跌倒在三级脊髓损伤 (SCI) 康复中是重中之重。跌倒可能导致患者或员工受伤、康复延迟和医院责任。目前，加拿大 SCI 康复机构中缺乏预防/管理跌倒的政策和程序的综合概述。我们描述并比较了在加拿大五个省份的六家三级康复医院实施的预防/管理跌倒的政策和程序。
使用文献分析对来自加拿大五个省份的六家三级康复医院的 SCI 康复中实施的预防/管理跌倒文件进行了分析。分析包括对文件进行多次阅读，然后进行内容和主题文献分析。
SCI 康复中的跌倒预防/管理政策和程序分为三大类：1）防跌倒政策和程序；2）跌倒后政策和程序；以及，3）员工、患者和家属之间的沟通。防跌倒政策和程序包括：a）跌倒的定义；b）SCI 康复中的跌倒风险评估；和，c）跌倒预防策略。跌倒后政策和程序包括：a）从跌倒中恢复；b）事件报告流程；和，c）跌倒分类。医院之间存在差异的跌倒预防/管理政策和实践的组成部分包括跌倒风险评估、跌倒后小组讨论和跌倒分类。
预防/管理跌倒是所有医院的必要组织实践。尽管提供 SCI 康复的加拿大三级医院具有相似的预防/管理跌倒政策和程序组成部分，但每个地点的具体要求都不同。需要在加拿大 SCI 康复环境中以证据为基础，达成共识来实施具体的 SCI 跌倒预防和管理程序。
