Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-05T00:45:33.584Z Has data issue: false hasContentIssue false
  • English
  • Français

Post-fall reporting in aged acute inpatient mental health units: an 18-month observational cohort study

Published online by Cambridge University Press:  04 September 2017

Trentham Furness Open the ORCID record for Trentham Furness [Opens in a new window] ,
George Mnatzaganian ,
Robyn Garlick ,
Susan Ireland ,
Brian McKenna  and
Keith D. Hill
Trentham Furness*
Affiliation:
School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia NorthWestern Mental Health, The Royal Melbourne Hospital, Parkville, Victoria, Australia
George Mnatzaganian
Affiliation:
College of Science, Health and Engineering, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
Robyn Garlick
Affiliation:
NorthWestern Mental Health, The Royal Melbourne Hospital, Parkville, Victoria, Australia
Susan Ireland
Affiliation:
NorthWestern Mental Health, The Royal Melbourne Hospital, Parkville, Victoria, Australia
Brian McKenna
Affiliation:
School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand Auckland Regional Forensic Psychiatry Services, Waitemata District Health Board, Auckland, New Zealand
Keith D. Hill
Affiliation:
School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
*
Correspondence should be addressed to: Trentham Furness, NorthWestern Mental Health, The Royal Melbourne Hospital, Grattan Street, Parkville, Victoria 3050, Australia. Phone: +61 3 9342-8255. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Despite the high risk of falling for people with severe mental illness, there is limited falls research in mental health settings. Therefore, the objective of this observational cohort study was to conduct a focused post-fall review of fall episodes within aged acute inpatient mental health units at one of Australia's largest publicly funded mental health organizations.

Methods:

A post-fall reporting tool was developed to collect intrinsic and extrinsic fall risk factors among three aged acute mental health inpatient units over an 18-month period. Descriptive and inferential analyses were conducted to describe fall risk factors and predictors of fall risk.

Results:

There were a total of 115 falls, of which the tool was used for 93 (80.9%) episodes. Falls occurred most often in consumer's bedroom/bathroom and were unwitnessed. Intrinsic risk factors were most often attributed to postural drop and losing balance during walking. However, that was in contrast to consumer's who self-reported feeling dizzy as the reason of the fall.

Conclusions:

Based on the cohort, future falls could be reduced by targeting those aged above 82 years, or with a diagnosis of dementia. Recurrent falls during admission could be reduced by targeting those with psychotic illness and males with a diagnosis of dementia. A clearer dialogue among consumers and clinical staff reporting about fall episodes may support future remedial interventions and inform programs to reduce fall risk and assist the challenge of describing unwitnessed falls in aged acute inpatient mental health settings.

Keywords

fallsagingclinical assessmentdementiaprimary carepsychosisrisk factorsschizophrenia
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 12 , December 2017 , pp. 2007 - 2016
Copyright
Copyright © International Psychogeriatric Association 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

An, F. R., Xiang, Y. T., Lu, J. Y., Lai, K. and Ungvari, G. (2009). Falls in a psychiatric institution in Beijing, China. Perspectives in Psychiatric Care, 45, 183–190.CrossRefGoogle Scholar
Australian Bureau of Statistics. (2012). Causes of death 2010. Cat. no. 3303.0. Canberra: ABS.Google Scholar
Bradley, C. (2012). Hospitalisations due to falls by older people, Australia 2007–08. Injury research and statistics series no. 61. Cat. no. INJCAT 137. Canberra, Australia AIHW.Google Scholar
Brown, P. and Calnan, M. (2016). Chains of (dis)trust: exploring the underpinnings of knowledge-sharing and quality care across mental health services. Sociology of Health & Illness, 38, 286–305.CrossRefGoogle ScholarPubMed
Bunn, F. et al. (2014). Preventing falls among older people with mental health problems: a systematic review. BMC Nursing, 13, 4.CrossRefGoogle ScholarPubMed
Centre for Disease Control and Prevention. (2015). Important Facts About Falls. Atlanta, GA: Centre for Disease Control and Prevention. Available at: https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html; last accessed 01 August 2016.Google Scholar
Chang, J. et al. (2004). Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. BMJ, 328, 680.CrossRefGoogle ScholarPubMed
de Carle, J. and Kohn, R. (2001). Risk factors for falling in a psychogeriatric unit. International Journal of Geriatric Psychiatry, 16, 762–767.CrossRefGoogle Scholar
Deandrea, S., Lucenteforte, E., Bravi, F., Foschi, R., La Vecchia, C. and Negri, E. (2010). Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology, 21, 658–668.CrossRefGoogle ScholarPubMed
Department of Human Services. (2004). Minimising the Risk of Falls & Fall-related Injuries: Guidelines for Acute, Sub-acute and Residential Care Settings. Melbourne, Victoria: Metropolitan Health and Aged Care Services Division.Google Scholar
Downe-Wamboldt, B. (1992). Content analysis: methods, applications, and issues. Health Care for Women International, 13, 313–321.CrossRefGoogle ScholarPubMed
Figueroa, J., Basford, J. and Low, P. (2010). Preventing and treating orthostatic hypotension: as easy as A, B, C. Cleveland Clinic Journal of Medicine, 77, 298–306.CrossRefGoogle ScholarPubMed
Furness, T. and Maschette, W. (2009). Influence of whole body vibration platform frequency on neuromuscular performance of community-dwelling older adults. Journal of Strength and Conditioning Research, 23, 1508–1513.CrossRefGoogle ScholarPubMed
Greene, E., Cunningham, C., Eustace, A., Kidd, N., Clare, A. and Lawlor, A. (2001). Recurrent falls are associated with increased length of stay in elderly psychiatric inpatients. International Journal of Geriatric Psychiatry, 16, 965–968.CrossRefGoogle ScholarPubMed
Heslop, K. et al. (2012). Assessing falls risk in older adults mental health patients: a Western Australian review. International Journal of Mental Health Nursing, 21, 567–575.CrossRefGoogle ScholarPubMed
Heslop, K., Wynaden, D. and Tohotoa, J. (2014). Preventing falls in in-patient older adult mental health services: different causative factors in mental and neurocognitive disorders. Gerontology & Geriatric Research, 3, 4.Google Scholar
Horsfall, J., Cleary, M. and Hunt, G. (2010). Acute inpatient units in a comprehensive (integrated) mental health system: a review of the literature. Issues in Mental Health Nursing, 31, 273–278.CrossRefGoogle Scholar
Ismail, Z. et al. (2015). Associations of medical comorbidity, psychosis, pain, and capacity with psychiatric hospital length of stay in geriatric impatiens with and without dementia. International Psychogeriatrics, 27, 313– 321.CrossRefGoogle Scholar
Mann, C. (2003). Observational research methods. Research design II: cohort, cross sectional, and case-control studies. Emergency Medicine Journal, 20, 54–60.CrossRefGoogle ScholarPubMed
Matarese, M., Ivziku, D., Bartolozzi, F., Piredda, M. and De Marinis, M. (2015). Systematic review of fall risk screening tools for older patients in acute hospitals. Journal of Advanced Nursing, 71, 1198–1209.CrossRefGoogle ScholarPubMed
Oliver, D. and Healey, F. (2009). Falls risk prediction tools for hospital inpatients: do they work? Nursing Times, 105, 18–21.Google ScholarPubMed
Robinovitch, S. et al. (2013). Video capture of the circumstances of falls in elderly people residing in long-term care: an observational study. The Lancet, 381, 47–54.CrossRefGoogle ScholarPubMed
Saverino, A., Moriarty, A., Rantell, K., Waller, D., Ayres, R. and Playford, D. (2015). A qualitative description of falls in a neuro-rehabilitation unit: the use of standardised fall reporting including the International Classification of Functioning (ICF) to describe activities and environmental factors. Disability and Rehabilitation, 37, 355–362.CrossRefGoogle Scholar
Schwendimann, R., Bühler, H., De Geest, S. and Milisen, K. (2008). Characteristics of hospital inpatient falls across clinical departments. Gerontology, 54, 342–348.CrossRefGoogle ScholarPubMed
Stapleton, C., Hough, P., Bull, K., Hill, K., Greenwood, K. and Oldmeadow, L. (2009). A four-item falls risk screening tool for sub-acute and residential care: the first step in falls prevention. Australasian Journal on Ageing, 28, 139–143.CrossRefGoogle Scholar
Stubbs, B. (2011). Falls in older adult psychiatric patients: equipping nurses with knowledge to make a difference. Journal of Psychiatric and Mental Health Nursing, 18, 457–462.CrossRefGoogle Scholar
Tseng, C. C., Su, P. Y., Huang, H. T., Chang, Y. C. and Tai, Y. M. (2013). Risk factors for inpatient falls at a mental hospital. Taiwanese Journal of Psychiatry, 27, 131–139.Google Scholar
Victor, C., Dickinson, A., Narayanan, V., Simpson, C., Griffiths, C. and Humphrey, D. (2014). Falling in acute mental health settings for older people: who falls, where, when and why? Gerontology & Geriatric Research, 3, 4.Google Scholar
World Health Organisation. (2007). WHO Global Report on Falls Prevention in Older Age. Geneva, Switzerland: World Health Organization. Available at: http://www.who.int/ageing/publications/Falls_prevention7March.pdf; last accessed 01 August 2016.Google Scholar
World Health Organisation. (2016). Falls. Geneva, Switzerland: World Health Organization. Available at: http://www.who.int/mediacentre/factsheets/fs344/en/; last accessed 01 August 2016.Google Scholar
Supplementary material: File

Furness et al supplementary material 1

Supplementary Table

Download Furness et al supplementary material 1(File)
File 37.2 KB