De Franceschi Valentina, Visentin Andrea
Corso di Laurea Magistrale in Scienze Riabilitative, Università degli studi di Padova, Azienda ULSS 6 Euganea, Padova.
Dipartimento di Medicina, Unità di Ematologia, Università di Padova, Padova, Italia.
Ig Sanita Pubbl. 2025 Mar-Apr;95(2):55-65.
Hospital falls represent a critical patient safety issue, despite being potentially preventable events. Effective management is carried out through clinical risk assessment and requires a thorough evaluation of risk factors, incident reporting, and the implementation of targeted interventions. This study focuses on analyzing falls in a healthcare organization in Northern Italy during the period 2020-2022, examining variables such as risk factors, fall locations, and clinical and organizational consequences.
To quantify and analyze hospital falls within the examined healthcare organization, stratifying by age, gender, operational unit, fall location, intrinsic and extrinsic factors, and assessing the impact on patients in terms of diagnostic tests, reported injuries, and management of incident reporting forms. Additionally, the study aims to evaluate existing organizational proposals for fall management adopted by the healthcare organization.
A retrospective, multicenter study conducted across five hospitals in a healthcare organization in Northern Italy, based on incident reporting data from 2020 to 2022. Statistical analysis includes the Kruskal-Wallis test, Dunn's test, Fisher's exact test, and the Chi-square test for continuous and categorical variables.
In a study of 1,032 incident reporting cases in a hospital, most falls (0.85% of the total) occurred primarily in hospital rooms (64.2%). The most common extrinsic factors included inappropriate footwear (17%). The medical area (58.33%) was the most affected by falls. Among intrinsic factors, 28% of cases showed cognitive deficits, while 13% had urinary and fecal urgency. Significant injuries were reported in 26% of patients, including contusions and fractures, with 23 sentinel events. Comparing the five hospitals (Hospital 1, Hospital 2, Hospital 3, Hospital 4, Hospital 5), falls were most frequent in hospital rooms (67.18%), with the most common extrinsic factors including inappropriate footwear (up to 26.3%). Significant intrinsic factors included cognitive deficits (up to 40%) and urinary/fecal urgency (up to 13.1%). Patient injuries were reported in approximately 28% of cases, with various hospitals highlighting specific issues such as incomplete incident reporting forms.
Hospital falls are influenced by multiple factors, including physical environments and patients' clinical conditions. Educational interventions and procedural reviews have contributed to improved risk management. It is essential to promote a hospital safety culture through integrated strategies addressing both human and organizational factors.
Effective management of falls in hospitals within the Northern Italy healthcare organization requires multidimensional approaches and targeted interventions based on evidence. Implementing initiatives such as staff training and procedural revisions is crucial to improving patient safety and optimizing healthcare services.
医院跌倒虽是潜在可预防事件，但却是一个关键的患者安全问题。通过临床风险评估进行有效管理，这需要对风险因素进行全面评估、事件报告以及实施有针对性的干预措施。本研究聚焦于分析意大利北部一家医疗机构在2020年至2022年期间的跌倒情况，研究风险因素、跌倒地点以及临床和组织后果等变量。
量化和分析所研究的医疗机构内的医院跌倒情况，按年龄、性别、业务科室、跌倒地点、内在和外在因素进行分层，并评估在诊断检查、报告的损伤以及事件报告表管理方面对患者的影响。此外，该研究旨在评估该医疗机构采用的现有跌倒管理组织建议。
一项回顾性多中心研究，基于意大利北部一家医疗机构五家医院2020年至2022年的事件报告数据开展。统计分析包括对连续变量和分类变量的Kruskal-Wallis检验、Dunn检验、Fisher精确检验以及卡方检验。
在一家医院对1032例事件报告病例的研究中，大多数跌倒（占总数的0.85%）主要发生在病房（64.2%）。最常见的外在因素包括鞋类不合适（17%）。医疗区域受跌倒影响最大（58.33%）。在内在因素中，28%的病例存在认知缺陷，而13%有大小便失禁。26%的患者报告有严重损伤，包括挫伤和骨折，有23起警戒事件。比较五家医院（医院1、医院2、医院3、医院4、医院5），跌倒在病房最为频繁（67.18%），最常见的外在因素包括鞋类不合适（高达26.3%）。重要的内在因素包括认知缺陷（高达40%）和大小便失禁（高达13.1%）。约28%的病例报告有患者受伤，各医院突出了一些具体问题，如事件报告表填写不完整。
医院跌倒受多种因素影响，包括物理环境和患者的临床状况。教育干预和程序审查有助于改善风险管理。通过综合解决人为和组织因素的策略来促进医院安全文化至关重要。
在意大利北部医疗机构内有效管理医院跌倒需要基于证据的多维度方法和有针对性的干预措施。实施员工培训和程序修订等举措对于提高患者安全和优化医疗服务至关重要。
