Maria José Costa-Dias1, Alexandre Santos Oliveira1, Teresa Martins2, Fátima Araújo2, Ana Sofia Santos3, Cristina Nogueira Moreira3, Helena José4. 1. Institute of Health Sciences, Catholic University of Portugal, Lisbon, Portugal. 2. Nursing School, Porto, Portugal. 3. Unit of Continuing and Palliative Care, Hospital da Luz, S.A., Lisbon, Portugal. 4. Catholic University of Portugal, Lisbon, Portugal; European Academy of Nursing Science, United Kingdom. Electronic address: hjose@ics.lisboa.ucp.pt.
Abstract
BACKGROUND: While the causes of falls in old hospitalized patients are multifactorial, medication has been considered as one of the most significant factors. Given the large impact that this phenomenon has on the lives of the elderly and organizations, it is important to explore such phenomenon in greater depth. OBJECTIVE: The objective of this study was to explore the association between medication and falls and the recurrent falls (n≥2), and identify medication related risk for fall in hospitalized patients, in a large acute hospital. DESIGN: Retrospective and quantitative study from June 2008 to December 2010. SETTING: The study was conducted in a private hospital for acute patients in Lisbon, Portugal. PARTICIPANTS: The study included a sample of 214 episodes of fall event notifications which occurred in 193 patients. METHODS: The current study was conducted through the "face to face consensus" technique which emerged the treatment groups to investigate. Regarding the data analysis we used Student's t test, ANOVA and Odds Ratio. In the violation of the premises for the use of parametric statistics we used the Kruskal-Wallis test. To assess the fall risk, and the medication-related fall risk, we used the Morse Fall Risk Scale, and the Medication Fall Risk Score. RESULTS: Patients who received drugs from the therapy group of "Central Nervous System", are 10 times more likely to have fall risk (OR 9. 90, 95% CI 1.6-60.63). Association was found between falls (OR 6.09, 95% CI 1.30-28.54) and its recurrence (OR 3.32, 95% CI 1.61-6.85), among patients receiving haloperidol and receiving tramadol for recurrent falls (OR 3.10, 95% CI 1.59-6.07). In 34% of the patients the medication fall risk score was 6 or higher. CONCLUSIONS: This current study allowed identifying medication-related risk factors for falls, that nurses should consider when prescribing interventions to prevent falls and its recurrence, when patients are admitted to acute care hospitals.
BACKGROUND: While the causes of falls in old hospitalized patients are multifactorial, medication has been considered as one of the most significant factors. Given the large impact that this phenomenon has on the lives of the elderly and organizations, it is important to explore such phenomenon in greater depth. OBJECTIVE: The objective of this study was to explore the association between medication and falls and the recurrent falls (n≥2), and identify medication related risk for fall in hospitalized patients, in a large acute hospital. DESIGN: Retrospective and quantitative study from June 2008 to December 2010. SETTING: The study was conducted in a private hospital for acute patients in Lisbon, Portugal. PARTICIPANTS: The study included a sample of 214 episodes of fall event notifications which occurred in 193 patients. METHODS: The current study was conducted through the "face to face consensus" technique which emerged the treatment groups to investigate. Regarding the data analysis we used Student's t test, ANOVA and Odds Ratio. In the violation of the premises for the use of parametric statistics we used the Kruskal-Wallis test. To assess the fall risk, and the medication-related fall risk, we used the Morse Fall Risk Scale, and the Medication Fall Risk Score. RESULTS:Patients who received drugs from the therapy group of "Central Nervous System", are 10 times more likely to have fall risk (OR 9. 90, 95% CI 1.6-60.63). Association was found between falls (OR 6.09, 95% CI 1.30-28.54) and its recurrence (OR 3.32, 95% CI 1.61-6.85), among patients receiving haloperidol and receiving tramadol for recurrent falls (OR 3.10, 95% CI 1.59-6.07). In 34% of the patients the medication fall risk score was 6 or higher. CONCLUSIONS: This current study allowed identifying medication-related risk factors for falls, that nurses should consider when prescribing interventions to prevent falls and its recurrence, when patients are admitted to acute care hospitals.
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