We aimed to investigate and analyze reports of accidents and near-miss incidents during physiotherapy over the past ten years.
We conducted a search using the website of the Japan Council for Quality Health Care's Medical Accident Information Collection Project. The search parameters were set from January 2010 to March 2022, with no restriction on the location of incidents. The profession involved was set to PT (Physical Therapist), and the keyword was "fall." We excluded 154 cases where the patient did not fall during physical therapy, cases of death due to sudden changes in the patient's condition, incidents caused by the physical therapist's pre-existing conditions leading to loss of consciousness, and cases with missing patient information. The classification of the severity of incidents was based on the classification system of the National University Hospital Council of Japan, and we reclassified the cases accordingly. We used the Kruskal-Wallis test to analyze differences in severity across experience years, accident occurrence situations, and the relationship between these variables. The Spearman rank correlation coefficient was used to test the correlation between experience years and severity.
Classifying the reported cases by disease type revealed that orthopedic, neurological, and internal diseases were the most common. By activity at the time of the accident, walking, standing, and sitting were the most frequent. About half of the reported incidents occurred among physical therapists with 0 to 4 years of experience. The correlation between years of experience and severity was p=0.02, but with r=0.189, showing little correlation. No significant differences in severity were found across experience groups. More than half of the accidents occurred when the physical therapist was nearby (either assisting or supervising closely).
Due to the limitations in understanding the total number of physical therapy sessions or specific characteristics of each hospital, we cannot draw definitive conclusions about the relationship between years of experience and accident reports. However, previous research at the same facility found a strong negative correlation between years of experience and incident reports, suggesting some relationship between experience and accidents. In this study, no correlation was found between years of experience and severity, and previous research has only shown a weak negative correlation, indicating that a patient's fall severity may not be affected by therapist experience. Similar to previous studies, more than half of the incidents occurred when the physical therapist was nearby. In such cases, the severity of the impact on the patient tended to be lower. This suggests that staying close to the patient is important in reducing the severity of accidents.
Although therapist experience is essential to prevent fall accidents in patients during physiotherapy, patient falls may occur and could be severe independently of the experience. Staying close to the patient during physiotherapy is important in reducing the severity of accidents, and a continuous prevention program is needed to prevent future falls.
Fall prevention
Risk management
