Authors (including presenting author) :
Wong SL(1), Lam SF(2)
Affiliation :
Kwai Chung Hospital
Introduction :
Fall represents a significant concern within the inpatient population, and the incidence of falls among psychiatric inpatients is markedly elevated in comparison to the general hospital population (Abraham, 2016). The higher prevalence stems from a complex interplay of factors intrinsic to the psychiatric patient experience (Turner et al., 2020), such as the influence of psychiatric diagnoses themselves, the side effects of prescribed psychotropic medications, and the presence of comorbid medical conditions.
Existing literature on falls may tend to focus more on geriatric psychiatric patients (Suga et al., 2020), while studies on younger adult psychiatric inpatients have found distinctive patient-related risk factors (Knight & Coakley, 2010), which imply that the factors leading to falls in younger patients should not be overlooked. Although the HA adopted the Morse Fall Scale with periodic re-assessments to effectively screen out high fall risk cases, literature concluded there is no perfect prediction from fall risk assessment tools. Even the most adoptable instrument provide no significant benefit over a nurse's clinical judgement in fall risk assessment (Majkusová & Jarošová, 2017).
Given this phenomenon, we need to inform local nurses about the factors leading to fall cases in our local setting to enhance their clinical judgement. However, local studies on psychiatric patient fall factors are scarce, and there is low generalizability from research conducted on different clinical cohorts. This knowledge gap highlights the urge to review patient-related risk factors in younger psychiatric patients. Therefore, this study aims to investigate patient-related risk factors for younger adults in previous psychiatric inpatient falls at Kwai Chung Hospital, and develop a cue card to remind staff of the significant factors to assist their clinical judgement.
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Objectives :
i) Identify patient-related risk factors for younger adults in previous psychiatric inpatient falls.
ii) Develop and provide frontline nurse a cue card displaying significant factors.
Methodology :
This retrospective study followed a methodological approach used by Young-Xu et al. (2019), which explored the prevalence and trends of falls within a veterans' health care hospital. Our research utilized six years of data at a local psychiatric hospital from AIRS, the organizational reporting system, adopting the organization's definition of a fall for inclusion criteria: A fall is an event that results in a person coming to rest inadvertently on the ground or floor or other lower level. Only the first fall episode was included in the analysis for patients with multiple falls. The study concentrated on fall cases involving psychiatric inpatients aged 18 to 65, with reported fall from 1/1/2018 to 31/12/2024.
For each included cases comprehensive information was gathered, including patient demographic data, drug regimen, duration of hospitalization, history of falls, comorbid medical conditions, psychiatric diagnosis, and level of mobility at the time of the incident. A multiple linear regression was performed to quantify the relationships between the identified risk factors and the likelihood of fall events.
Young-Xu, Y., Soncrant, C., Neily, J., Boar, S., Bulat, T., & Mills, P. D. (2019). Falls in Veterans Healthcare Administration Hospitals: Prevalence and Trends. Journal for Healthcare Quality, 42(3), 113–121.
Result & Outcome :
Currently under data collection. Analysis and significant findings are planned to be completed and obtained before late 4/2024.
