Wallis Allison, Aggar Christina, Massey Deb
Northern NSW Local Health District, Northern NSW Australia.
School of Health and Human Sciences, Southern Cross University, Northern NSW Australia.
Contemp Nurse. 2025 Apr-Jun;61(3):257-269. doi: 10.1080/10376178.2024.2420088. Epub 2024 Nov 12.
: Falls are the most reported patient safety incident for patients >65 years in acute hospital settings worldwide. While multifactorial fall interventions reduce the number of falls in subacute and rehabilitation settings, fall interventions in acute hospital settings are unknown.: To evaluate the effectiveness of multifactorial fall interventions on the number of falls using codesigned education targeting staff and the patient and review the environment in acute hospital settings in NSW, Australia for patients over 65 years of age.: A pre-post-test design with a non-equivalent group was conducted. All acute hospital inpatient falls occurring both pre- and post-intervention within one health district were included in this study. The use of Quality Improvement methodology identified gaps in risk screening and assessment, education and information, communication of risk, and standardised fall prevention equipment. Codesigned interventions to address these gaps were undertaken.: The number of falls ( = 0.038) and injurious falls ( < 0.001) significantly decreased in the post-intervention group. There was a significant improvement in fall assessments ( < 0.001), delirium risk screening ( < 0.001), the provision of fall information ( < 0.001) and fall risk discussed at shift handover ( < 0.001) in the post-intervention group. Following the intervention, staff were significantly more likely to undertake fall education modules ( < 0.001) and develop a fall management plan ( < 0.001).: Falls continue to have a significant economic impact on the acute hospital setting. Our findings highlight multifactorial fall interventions that included staff and patients in the development phases reduced the number of falls. Multifactorial fall interventions targeting staff, patients and the environment may influence a reduction in the number of falls and the severity of falls in the acute hospital setting.
在全球急性医院环境中,跌倒在65岁以上患者中是报告最多的患者安全事件。虽然多因素跌倒干预措施可减少亚急性和康复环境中的跌倒次数,但急性医院环境中的跌倒干预效果尚不清楚。
为了评估针对工作人员和患者进行联合设计教育的多因素跌倒干预措施对跌倒次数的有效性,并对澳大利亚新南威尔士州急性医院环境中65岁以上患者的环境进行评估。
采用非等效组的前后测试设计。本研究纳入了一个卫生区内干预前后发生的所有急性医院住院患者跌倒事件。运用质量改进方法确定了风险筛查与评估、教育与信息、风险沟通以及标准化跌倒预防设备方面的差距。针对这些差距采取了联合设计的干预措施。
干预后组的跌倒次数(=0.038)和致伤性跌倒次数(<0.001)显著减少。干预后组在跌倒评估(<0.001)、谵妄风险筛查(<0.001)、跌倒信息提供(<0.001)以及交接班时讨论跌倒风险(<0.001)方面有显著改善。干预后,工作人员更有可能参加跌倒教育模块(<0.001)并制定跌倒管理计划(<0.001)。
跌倒继续对急性医院环境产生重大经济影响。我们的研究结果表明,在开发阶段将工作人员和患者纳入其中的多因素跌倒干预措施减少了跌倒次数。针对工作人员、患者和环境的多因素跌倒干预措施可能会减少急性医院环境中的跌倒次数和跌倒严重程度。