Hatsusegawa H1, Yamada M2, Yokota N1, Miyazaki N1, Sugimoto K1, Fukada M1, Kimoto M1
1Saito Rehabilitation Hospital, Osaka, Japan, 2Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
Background: Incidents of older patients falling while under hospitalization is a serious event, leading to dire consequences. Therefore, it is important to prevent such circumstances from occurring.
Purpose: This study investigated the characteristics and circumstances of falls at the rehabilitation unit.
Methods: We used a retrospective cohort design. We noted the data of falling incidents of 286 patients at our rehabilitation unit. The falls were reported by clinical staff, such as physical therapists, occupational therapists, and nurses. We excluded patients who experienced falling more than once from our database; therefore, fall incidents of 192 patients were analyzed in this study. These patients were divided into three groups: those who fell during rehabilitation (RH, n = 43), those who fell during non-rehabilitation (N-RH, n = 128), and those who fell during both rehabilitation and non-rehabilitation (MIX, n = 21). We investigated demographic information, physical function, and fall situation for patients using medical records. In addition, we evaluated to each therapists for patients with fell down about cognition and awareness of patients before the fall incident using the Visual Analogue Scale in questionnaires (0 = think so, 10 = not think so).
Results: The mean ages (proportion of males and proportion of patients affected by stroke) of patients in the RH group, N-RH group, and MIX group were 73.7 ± 12.2 years (34.9%, 25.6%), 77.6 ± 11.6 years (53.9%, 35.9%), and 63.8 ± 16.6 years (66.7%, 61.9%), respectively. The total Functional Independence Measure score was higher in the RH group than in other groups (RH, 88.5 ± 26.4; N-RH, 68.6 ± 24.7; and MIX, 69.0 ± 23.4) (P 0.05). In the RH group, 25 (58%) patients fell while walking, and most of them (76%) were attempting a higher level of walking when they fell. Additionally, as per the questionnaire results, they were not careful enough and were not able to predict the falls.
Conclusion(s): Patients in the RH group showed higher physical and cognitive function than patients of the other groups, and most patients of the RH group were attempting a higher level of walking. Moreover, the relationship between fall incident and carelessness of the therapists was our most serious concern.
Implications: These findings suggest that it may be possible to decrease fall incidents during hospitalization if some educational interventions are conducted for therapists as well patients that can lead to better awareness.
Keywords: fall, during rehabilitation, hospitalization
Funding acknowledgements: The study is not funded.
Purpose: This study investigated the characteristics and circumstances of falls at the rehabilitation unit.
Methods: We used a retrospective cohort design. We noted the data of falling incidents of 286 patients at our rehabilitation unit. The falls were reported by clinical staff, such as physical therapists, occupational therapists, and nurses. We excluded patients who experienced falling more than once from our database; therefore, fall incidents of 192 patients were analyzed in this study. These patients were divided into three groups: those who fell during rehabilitation (RH, n = 43), those who fell during non-rehabilitation (N-RH, n = 128), and those who fell during both rehabilitation and non-rehabilitation (MIX, n = 21). We investigated demographic information, physical function, and fall situation for patients using medical records. In addition, we evaluated to each therapists for patients with fell down about cognition and awareness of patients before the fall incident using the Visual Analogue Scale in questionnaires (0 = think so, 10 = not think so).
Results: The mean ages (proportion of males and proportion of patients affected by stroke) of patients in the RH group, N-RH group, and MIX group were 73.7 ± 12.2 years (34.9%, 25.6%), 77.6 ± 11.6 years (53.9%, 35.9%), and 63.8 ± 16.6 years (66.7%, 61.9%), respectively. The total Functional Independence Measure score was higher in the RH group than in other groups (RH, 88.5 ± 26.4; N-RH, 68.6 ± 24.7; and MIX, 69.0 ± 23.4) (P 0.05). In the RH group, 25 (58%) patients fell while walking, and most of them (76%) were attempting a higher level of walking when they fell. Additionally, as per the questionnaire results, they were not careful enough and were not able to predict the falls.
Conclusion(s): Patients in the RH group showed higher physical and cognitive function than patients of the other groups, and most patients of the RH group were attempting a higher level of walking. Moreover, the relationship between fall incident and carelessness of the therapists was our most serious concern.
Implications: These findings suggest that it may be possible to decrease fall incidents during hospitalization if some educational interventions are conducted for therapists as well patients that can lead to better awareness.
Keywords: fall, during rehabilitation, hospitalization
Funding acknowledgements: The study is not funded.
Topic: Older people; Disability & rehabilitation; Education: clinical
Ethics approval required: Yes
Institution: Saito Rehabilitation Hospital
Ethics committee: Medical Ethical Committee of the Saito Rehabilitation Hospital
Ethics number: SR-2017-2
All authors, affiliations and abstracts have been published as submitted.
