From the Centralized Workforce Scheduling and Timekeeping, Royal Victoria Regional Health Centre.
Patient Safety & Experience, Royal Victoria Regional Health Centre.
J Patient Saf. 2024 Sep 1;20(6):434-439. doi: 10.1097/PTS.0000000000001237. Epub 2024 Jun 26.
Falls with harms (FWH) in hospitalized patients increase costs and lengths of stay. The COVID-19 pandemic has resulted in more FWH. Additionally, the COVID-19 pandemic has resulted in increased patients in isolation with fewer visitors. Their relationship with falls has not been previously studied.
This is a retrospective, single-site, 12-month before pandemic-12-month after pandemic, observational study. Multiple logistic regression analysis was used to model FWH outcome and associations with isolation and visitor restrictions.
There were 4369 isolation events and 385 FWH among 22,505 admissions during the study period. Unadjusted analysis demonstrated a FWH risk of 1.33% (95% CI 0.99, 1.67) in those who were placed in isolation compared to 1.80% (95% CI 1.60, 2.00) in those without an isolation event ( χ2 = 4.73, P = 0.03). The FWH risk during the different visitor restriction periods was significantly higher compared to the prepandemic period ( χ2 = 20.81, P < 0.001), ranging from 1.28% (95% CI 1.06, 2.50) in the prepandemic period to 2.03% (95% 1.66, 2.40) with no visitors permitted (phase A) in the pandemic period. After adjusting for potential confounders and selection bias, only phase A visitor restrictions were associated with an increased FWH risk of 0.75% (95% CI 0.32, 1.18) compared to no visitor restrictions.
Our results suggest a moderately strong association between hospitalized patient FWH risk and severe visitor restrictions. This association was muted in phases with even minor allowances for visitation. This represents the first report of the adverse effects of visitor restriction policies on patients' FWH risks.
住院患者发生跌倒并造成伤害（FWH）会增加成本和住院时间。COVID-19 大流行导致了更多的 FWH。此外，COVID-19 大流行导致隔离患者增加，访客减少。他们与跌倒的关系尚未被研究过。
这是一项回顾性、单站点、大流行前 12 个月至大流行后 12 个月的观察性研究。采用多因素逻辑回归分析模型来预测 FWH 结果与隔离和访客限制的关系。
在研究期间，共有 22505 例住院患者发生了 4369 次隔离事件和 385 例 FWH。未经调整的分析显示，与未发生隔离事件的患者相比，隔离患者发生 FWH 的风险为 1.33%（95%CI 0.99，1.67），差异有统计学意义（ χ 2 = 4.73，P = 0.03）。在不同访客限制期间，FWH 的风险显著高于大流行前时期（ χ 2 = 20.81，P < 0.001），范围从大流行前时期的 1.28%（95%CI 1.06，2.50）到大流行期间访客被完全禁止时的 2.03%（95%CI 1.66，2.40）。在调整了潜在混杂因素和选择偏倚后，只有 A 期访客限制与 FWH 风险增加 0.75%（95%CI 0.32，1.18）相关，与无访客限制相比。
我们的研究结果表明，住院患者 FWH 风险与严格访客限制之间存在中度强关联。在访客限制稍有放宽的阶段，这种关联减弱。这是首次报告访客限制政策对患者 FWH 风险的不良影响。
