Wednesday, March 09, 2011

Research Abstract and Commentary:Patient Perspectives on Falls

Patients’ perspectives of falling while in an acute care hospital and suggestions for prevention

Patient falls and falls with injury are the largest category of reportable incidents and a significant problem in hospitals. Patients are an important part of fall prevention; therefore, we asked patients who have fallen about reason for fall and how falls could be prevented. There were two categories for falls: the need to toilet coupled with loss of balance and unexpected weakness. Patients asked to be included in fall risk communication and asked to be part of the team to prevent them from falling. Nurses need to share a consistent and clear message that they are there for patient safety.

Carroll, D. L., Dykes, P. C., & Hurley, A. C. (2010). Applied Nursing Research, 23, 238-241.

Commentary by Dana N. Rutledge, RN, PhD, Nursing Research Facilitator

Given the fact that patients continue to fall, these researchers sought to understand the unique views of patients who had fallen within 48 hrs of their fall while an inpatient in an acute care hospital. They interviewed 9 cognitively intact men and women with ages from 24 to 78 years. Six of the participants had fallen in the past.

Results were fascinating, with cogent excerpts from patient statements. Patients’ reasons given for falling made sense: losing one’s balance while in a hurry to get to the bathroom, being involved in a normal activity while weakened from the condition leading to hospitalization, and not having items within reach. Patients were able to come up with ideas to prevent their own falling in the future: thinking ahead and NOT getting up quickly or without help; asking for help when it is needed, and overcoming the natural instinct to “not bother” the nursing staff; and using appropriate assistive devices (e.g., walkers, slip resistant socks).

The study pointed clear messages to nurses:
• Give anticipatory guidance for patients at risk of falling.
• Help patients feel comfortable asking for help.
• When a patient requests help, respond quickly and positively.
• Think ahead to patients’ needs to prevent their needing to go beyond their capabilities.

Studies like this one which offer patient perspectives are so important for nurses to read and reflect on… please let us know in the Office of Nursing Research (714-771-8120; 12698) if you need help in this.


Amanda R. said...

I recently started working at a hospital and was shocked at how many patients are falling down during the day. It seems that during the busy hours on our floor (Tele unit) is when the most falls occur. Was there any mention on the time of day the patients fall occurred?

Dana Rutledge, RN, PhD said...

Amanda - good observation... this study did not address time of day of falls since patients were asked about their perceptions of WHY they fell and what could have prevented the fall(s). There are lots of published studies that do have data on time of day of falls... you can search for them in PubMed or CINAHL. Dr. R.