Meta-analysis: Multidisciplinary fall prevention strategies in the acute care inpatient population

2012 ◽  
Vol 7 (6) ◽  
pp. 497-503 ◽  
Author(s):  
David DiBardino ◽  
Elaine R. Cohen ◽  
Aashish Didwania
Keyword(s):  
Acute Care ◽  
Fall Prevention ◽  
Meta Analysis ◽  
Prevention Strategies ◽  
Inpatient Population

scholarly journals Reduction of Inpatient Fall Rate in an Adult Acute Care Setting

2021 ◽  
Author(s):  
◽  
Manjusha Maprel
Keyword(s):  
Acute Care ◽  
Fall Prevention ◽  
Fall Risk ◽  
The Elderly ◽  
Fall Rate ◽  
Prevention Strategies ◽  
Severe Injuries ◽  
Meaningful Improvement ◽  
Telemetry Unit ◽  
Practice Problem

Practice Problem: Falls are among the most reported hospital-acquired conditions and can lead to severe injuries, increased length of hospital stays, pain, distress, and emotional trauma in the elderly. The Centers for Medicare and Medicaid Services (CMS) identifies falls as preventable and no longer authorizes reimbursement to healthcare systems for treating inpatient fall-related injuries. PICOT: The PICOT question that guided this project was: In adult, acute care patients admitted to the telemetry unit (P), how does implementing evidence-based multimodal fall prevention strategies (I) compared to routine fall prevention strategies (C) affect inpatient fall rate (O) over a period of 6-8 weeks (T)? Evidence: The literature review revealed that using multimodal risk prevention strategies effectively reduces fall risk and fall-related injuries and thus improves patient safety and outcomes. Intervention: A multimodal fall prevention strategy was developed, according to the Morse Fall Risk Assessment score, utilizing tools such as bed alarm on, lights on, a urinal within reach, purposeful hourly rounding, and bedside reporting during shift change. The oncoming shift nurse checked with the off-going shift nurse at the patient’s bedside to ensure that the fall risk patients’ fall precaution strategies had been initiated and maintained throughout the shift. Outcome: The EBP project did not result in an overall reduction in the fall rates; however, the fall rate with injury was low in the telemetry unit. The project resulted in an increase in the staff’s knowledge and awareness of multimodal fall prevention strategies. Conclusion: The reduction in the incidence of falls after the implementation of the EBP project in the telemetry unit was not statistically significant. However, the result indicated a clinically meaningful improvement in fall-related injury outcomes and increased staff knowledge and awareness of the fall prevention strategies.

Two Sides to Every Fall: Patient and Nurse Perspectives

2020 ◽  
Vol 40 (6) ◽  
pp. 33-41
Author(s):  
Linda M. Hoke ◽  
Rachel T. Zekany
Keyword(s):  
Risk Factors ◽  
Content Analysis ◽  
Acute Care ◽  
Fall Prevention ◽  
Analysis Approach ◽  
Cardiac Care ◽  
Prevention Strategies ◽  
Factors Associated ◽  
Two Sides ◽  
Cardiac Care Unit

Background Despite vast evidence describing risk factors associated with falls and fall prevention strategies, falls continue to present challenges in acute care settings. Objective To describe and categorize patient and nurse perspectives on falls and nurses’ suggestions for preventing falls. Methods To improve transparency about the causes of falls, nurses interviewed patients in a 48-bed progressive cardiac care unit who had experienced a fall. A content analysis approach was used to examine responses to 3 open-ended items: why patients said they fell, why nurses said the patients fell, and nurses’ reflections on how each fall could have been prevented. Results Over a 2-year period, 67 falls occurred. Main themes regarding causes of falls were activity (41 falls, 61%), coordination (16 falls, 24%), and environment (10 falls, 15%). Patients said they fell because they slipped, had a medical issue, were dizzy, or had weak legs. Nurses said patients fell because they had a medical issue or did not call for assistance. Conclusions Nurses and patients agreed on the causes of assisted falls but disagreed on the causes of unassisted falls. Nurses frequently said that the use of a bed alarm could have prevented the fall.

scholarly journals Reduction of Inpatient Fall Rate in an Adult Acute Care Setting

2021 ◽  
Author(s):  
◽  
Manjusha Maprel
Keyword(s):  
Acute Care ◽  
Fall Prevention ◽  
Fall Risk ◽  
The Elderly ◽  
Fall Rate ◽  
Prevention Strategies ◽  
Severe Injuries ◽  
Meaningful Improvement ◽  
Telemetry Unit ◽  
Practice Problem

Practice Problem: Falls are among the most reported hospital-acquired conditions and can lead to severe injuries, increased length of hospital stays, pain, distress, and emotional trauma in the elderly. The Centers for Medicare and Medicaid Services (CMS) identifies falls as preventable and no longer authorizes reimbursement to healthcare systems for treating inpatient fall-related injuries. PICOT: The PICOT question that guided this project was: In adult, acute care patients admitted to the telemetry unit (P), how does implementing evidence-based multimodal fall prevention strategies (I) compared to routine fall prevention strategies (C) affect inpatient fall rate (O) over a period of 6-8 weeks (T)? Evidence: The literature review revealed that using multimodal risk prevention strategies effectively reduces fall risk and fall-related injuries and thus improves patient safety and outcomes. Intervention: A multimodal fall prevention strategy was developed, according to the Morse Fall Risk Assessment score, utilizing tools such as bed alarm on, lights on, a urinal within reach, purposeful hourly rounding, and bedside reporting during shift change. The oncoming shift nurse checked with the off-going shift nurse at the patient’s bedside to ensure that the fall risk patients’ fall precaution strategies had been initiated and maintained throughout the shift. Outcome: The EBP project did not result in an overall reduction in the fall rates; however, the fall rate with injury was low in the telemetry unit. The project resulted in an increase in the staff’s knowledge and awareness of multimodal fall prevention strategies. Conclusion: The reduction in the incidence of falls after the implementation of the EBP project in the telemetry unit was not statistically significant. However, the result indicated a clinically meaningful improvement in fall-related injury outcomes and increased staff knowledge and awareness of the fall prevention strategies.

scholarly journals A Systematic Review and Meta-Analysis of Fall Prevention Programs for Pediatric Inpatients

2021 ◽  
Vol 18 (11) ◽  
pp. 5853
Author(s):  
Eun-Joo Kim ◽  
Geun-Myun Kim ◽  
Ji-Young Lim
Keyword(s):  
High Risk ◽  
Fall Prevention ◽  
Prevention Program ◽  
Meta Analysis ◽  
Prevention Programs ◽  
Fall Prevention Program ◽  
Medium Risk ◽  
Randomized Control ◽  
Reduction Effect ◽  
Future Randomized Control Trial

Falls account for a high proportion of the safety accidents experienced by hospitalized children. This study aims to analyze the contents and effects of fall prevention programs for pediatric inpatients to develop more adaptable fall prevention programs. A literature search was performed using PubMed (including Medline), Science Direct, CINAHL, Embase, and Cochrane. We included articles published from the inception of each of the databases up to 31 March 2019. A total of 1725 results were reviewed according to the inclusion and exclusion criteria, and nine studies were selected. Data were analyzed using descriptive statistics and the Comprehensive Meta-Analysis program. Four of the nine studies divided their participants into a high-risk fall group and a low-or medium-risk fall group, and all studies used a high-risk sign/sticker as a common protocol guideline for its high-risk fall group. The odds ratio of 0.95 (95% Cl 0.550–1.640) for the fall prevention program in seven studies was not statistically significant. To develop a standardized fall prevention program in the future, randomized control trial studies that can objectively measure the fall rate reduction effect of the integrated fall prevention program need to be expanded.

scholarly journals 1719. Respiratory Syncytial Virus-Associated Hospitalization Rates among US Infants: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S843-S843
Author(s):  
John M McLaughlin ◽  
Farid L Khan ◽  
Heinz-Josef Schmitt ◽  
Yasmeen Agosti ◽  
Luis Jodar ◽  
...  
Keyword(s):  
Public Health ◽  
Respiratory Syncytial Virus ◽  
Active Surveillance ◽  
Meta Analysis ◽  
The United States ◽  
Administrative Claims ◽  
Prevention Strategies ◽  
Hospitalization Rates ◽  
Syncytial Virus ◽  
The Impact

Abstract Background Understanding the true magnitude of infant respiratory syncytial virus (RSV) burden is critical for determining the potential public-health benefit of RSV prevention strategies. Although global reviews of infant RSV burden exist, none have summarized data from the United States or evaluated how RSV burden estimates are influenced by variations in study design. Methods We performed a systematic literature review and meta-analysis of studies describing RSV-associated hospitalization rates among US infants. We also examined the impact of key study characteristics on these estimates. Results After review of 3058 articles through January 2020, we identified 25 studies with 31 unique estimates of RSV-associated hospitalization rates. Among US infants < 1 year of age, annual rates ranged from 8.4 to 40.8 per 1000 with a pooled rate= 19.4 (95%CI= 17.9–20.9). Study type was associated with RSV hospitalization rates (P =.003), with active surveillance studies having pooled rates per 1000 (11.1; 95%CI: 9.8–12.3) that were half that of studies based on administrative claims (21.4; 95%CI: 19.5–23.3) or modeling approaches (23.2; 95%CI: 20.2–26.2). Conclusion Applying the pooled rates identified in our review to the 2020 US birth cohort suggests that 73,680 to 86,020 RSV-associated infant hospitalizations occur each year. To date, public-health officials have used conservative estimates from active surveillance as the basis for defining US infant RSV burden. The full range of RSV-associated hospitalization rates identified in our review better characterizes the true RSV burden in infants and can better inform future evaluations of RSV prevention strategies. Disclosures John M. McLaughlin, PhD, Pfizer (Employee, Shareholder) Farid L. Khan, MPH, Pfizer (Employee, Shareholder) Heinz-Josef Schmitt, MD, Pfizer (Employee, Shareholder) Yasmeen Agosti, MD, Pfizer (Employee, Shareholder) Luis Jodar, PhD, Pfizer (Employee, Shareholder) Eric Simões, MD, Pfizer (Consultant, Research Grant or Support) David L. Swerdlow, MD, Pfizer (Employee, Shareholder)

Fall prevention education for older people being discharged from hospital: Educators’ perspectives

2021 ◽  
pp. 001789692110327
Author(s):  
Jacqueline Francis-Coad ◽  
Den-Ching A Lee ◽  
Terry P Haines ◽  
Meg E Morris ◽  
Steven M McPhail ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Fall Prevention ◽  
Older Patients ◽  
Education Programme ◽  
Prevention Strategies ◽  
Post Intervention ◽  
Prevention Education ◽  
Barriers And Enablers ◽  
Education Delivery ◽  
Fall Prevention Education

Objective: Falls are a significant problem for many older patients after hospital discharge. The purpose of this study was to evaluate the fidelity and impact of a tailored patient fall prevention education programme from the perspective of the educators who delivered the programme. Design: Qualitative sequential design. Setting: Three rehabilitation hospitals in Western Australia. Method: Three experienced physiotherapists trained as ‘educators’ to deliver a tailored fall prevention education programme to 195 older patients prior to hospital discharge, together with monthly telephone follow-up for 3 months after discharge. Educator–patient interactions were recorded in a standardised educator diary. Post-intervention, educators participated in a mini-focus group, providing their perspectives regarding education delivery and its impact on patient abilities to engage in fall prevention strategies. Data were analysed using deductive content analysis. Results: Educators followed up 184 (94%) patients, identifying multiple barriers and enablers affecting patient engagement in planned fall prevention strategies. Key barriers included unresolved medical conditions, reluctance to accept assistance on discharge, delays in assistive service provision, patient beliefs and perceptions about falls and, in some cases, patients’ absolving responsibility for recovery. Enablers were related to programme design, the completion of hospital discharge processes and support networks following discharge. Conclusion: Educators identified several barriers and enablers to programme delivery, receipt and enactment by older patients that contributed to the fidelity of the education programme. The consistent need for more patient support to enable improved enactment of plans and assist with safe recovery long after discharge warrants further attention at policy and health system levels.

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