College of Nursing, Seoul National University, Seoul, South Korea.
School of Nursing/Research Institute of Nursing Science, Hallym University, Chuncheon, Gangwon-do, South Korea.
J Adv Nurs. 2022 Nov;78(11):3641-3651. doi: 10.1111/jan.15254. Epub 2022 Apr 20.
In-hospital fall is one key safety issue in a healthcare setting. Although healthcare providers apply several strategies for preventing falls, falls still occur in hospitals. The aim of this study was to investigate patient-level and organizational-level factors influencing in-hospital falls.
A multicentre retrospective observational study.
This study used the national healthcare database and supplemented with organizational data obtained through a survey. Data extraction and survey were conducted between July and August 2020. A mixed-effect logistic regression model was used to analyse factors influencing in in-hospital falls.
A total of 43,286 patients admitted in 86 hospitals were included in this study. Fall rate was 0.85 per 1000 days. Length of stay was significantly longer for fall patients than for no-fall patients. Patient-level factors (including age, mobility impairment and surgery) and organizational-level factors (including nurse staffing and proportion of new nurses) were significant factors influencing in-hospital falls.
Since in-hospital falls increase economic burden to patients, we should consider various fall prevention strategies to reduce falls. For a strategy to be applied stably to patients, organizational factors must be supported.
Proactive fall management in acute settings is essential to ensure patient safety. Considering that the number of patients with fall risk is increasing due to ageing, organizational factors should be supported to provide quality nursing care for fall risk patients. Therefore, nurse leaders should primarily ensure an appropriate level of nurse staffing. They also need to make efforts to strengthen clinical competency of nurses.
住院患者跌倒在医疗环境中是一个关键的安全问题。尽管医疗保健提供者采取了几种预防跌倒的策略，但医院仍会发生跌倒事件。本研究旨在调查影响住院患者跌倒的患者层面和组织层面的因素。
多中心回顾性观察研究。
本研究使用了国家医疗保健数据库，并通过调查补充了组织数据。数据提取和调查于 2020 年 7 月至 8 月进行。使用混合效应逻辑回归模型分析影响住院患者跌倒的因素。
本研究共纳入 86 家医院的 43286 名住院患者。跌倒率为每 1000 天 0.85 例。跌倒患者的住院时间明显长于无跌倒患者。患者层面的因素（包括年龄、活动能力受损和手术）和组织层面的因素（包括护士配备和新护士比例）是影响住院患者跌倒的显著因素。
由于住院患者跌倒会增加患者的经济负担，因此我们应考虑各种预防跌倒的策略来减少跌倒事件。为了使策略能够稳定地应用于患者，必须得到组织因素的支持。
积极管理急性病环境中的跌倒对于确保患者安全至关重要。考虑到由于人口老龄化，跌倒风险患者的数量正在增加，应支持组织因素为跌倒风险患者提供高质量的护理。因此，护理领导者应首先确保护士配备达到适当水平。他们还需要努力加强护士的临床能力。
