Fall prevention activities for inpatients at stroke rehabilitation setting and their impact on the incidence of falls
DOI:
https://doi.org/10.14528/snr.2014.48.3.26Keywords:
falls, prevention, stroke, inpatient rehabilitationAbstract
Introduction: Effective fall prevention is an important aspect of rehabilitation process. Multidisciplinary team approach, individual and specific activities all reduce the risk of falling of high risk patients. Methods: 1634 patients who were admitted to the stroke rehabilitation department of the University Rehabilitation Institute of the Republic of Slovenia - Soča (URI Soča) from January 1st 2007 to December 31st 2012 were all included in the study. Retrospective observational research with elements of action research was used to determine the efficiency of the fall prevention activities. The incidence of falls was used to evaluate the success of fall prevention activities. Results: The incidence of falls has been reduced from 4.5 falls/1000 hospital days (HD) in 2007 to 2.8 falls/1000 HD in 2012 during the implementation of general fall prevention activities, the use of the fall prevention scale and the implementation of systematic activities of the entire multidisciplinary rehabilitation team. The success of these preventive activities was evident in patients who fell once (p = 0.025). Discussion and conclusion: The incidence of falls in stroke patients during the rehabilitation process can be decreased significantly by multidisciplinary team approach in fall prevention activities. The influence of such activities in the fall prevention at home offers a suggestion for further research.Downloads
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Aberg, A.C., Lundin- Olsson, L. & Rosendahl, E., 2009. Implementation of evidence- based prevention of falls in rehabilitation units: a staffˈs interactive approach. Journal of Rehabilitation Medicine, 41(13), pp. 1034-1040. http://dx.doi.org/10.2340/16501977-0452, PMid:19893998
Andersson, A.G., Kamwendo, K., Seiger, A. & Appelros, P., 2006. How to identify potential fallers in a stroke unit: validity indexes of four test methods. Journal of Rehabilitation Medicine, 38(3), pp. 186-191. http://dx.doi.org/10.1080/16501970500478023, PMid:16702086
Barreca, S., Sigouin, C.S., Lambert, C. & Ansley, B., 2004. Effects of extra training on the ability of stroke survivors to perform an independent sit-to-stand: a randomized controlled trial. Journal of Geriatric Physical Therapy, 27(2), pp. 59-68. http://dx.doi.org/10.1519/00139143-200408000-00004
Batchelor, F.A., Macintosh, S.F., Said, C.M., & Hill, K.D., 2012. Falls after stroke. International Journal of Stroke,7(6), pp. 482-490. PMid:22494388
Campbell, A.J. & Robertson, M.C., 2006. Implementation of multifactorial interventions for fall and fracture prevention. Age and Ageing, 35 Suppl 2, pp. ii60-ii64. http://dx.doi.org/10.1093/ageing/afl089, PMid:16926208
Campbell, G.B., Breisinger, T.P. & Meyers, L., 2006. Stroke unit fall prevention: an interdisciplinary, data-driven approach. Rehabilitation Nursing, 31(1), pp. 3-4. http://dx.doi.org/10.1002/j.2048-7940.2006.tb00002.x, PMid:16422037
Coghlan, D. & Casey, M., 2001. Action research from inside: issues and challenges in doing action research in your own hospital. Journal of Advanced Nursing, 35(5), pp. 674-682. http://dx.doi.org/10.1046/j.1365-2648.2001.01899.x, PMid:11529969
Czernuszensko, A. & Czlonkowska, A., 2009. Risk factors for falls in stroke patients during inpatient rehabilitation. Clinical Rehabilitation, 23(2), pp. 176-188. http://dx.doi.org/10.1177/0269215508098894, PMid:19164405
Globokar, D. & Goljar, N., 2006. Napovedna vrednost Lestvice funkcijske neodvisnosti za rehabilitacijo bolnikov po možganski kapi na Inštitutu Republike Slovenije za rehabilitacijo. Rehabilitacija, 5(3/4), pp. 51-53.
Goljar, N. & Ivanovski, M., 2012. Motnje občutljivosti, zaznavnih in spoznavnih sposobnosti in izid rehabilitacije po možganski kapi. In: Marinček, Č. ed. Pomen zaznavnih in prepoznavnih sposobnosti v rehabilitacijski medicini. 23. dnevi rehabilitacijske medicine: zbornik predavanj, Ljubljana, 23. in 24. marec 2012. Ljubljana: Univerzitetni rehabilitacijski inštitut Republike Slovenije - Soča, pp. 88-94.
Grabljevec, K., 2003. Lestvica funkcijske neodvisnosti (FIM). In: Burger, H. & Goljar, N., eds. Ocenjevanje izida v medicinski rehabilitaciji. 14. dnevi rehabilitacijske medicine: zbornik predavanj, Ljubljana, 4. in 5. april 2003. Ljubljana: Inštitut Republike Slovenije za rehabilitacijo, pp. 59-64.
Haines, T.P., Bennell, K.L., Osborne, R.H. & Hill, K.D., 2004. Effectiveness of targeted falls prevention programme in subacute hospital setting: randomised controlled trial. British Medical Journal, 328(7441), pp. 328-336. http://dx.doi.org/10.1136/bmj.328.7441.676; PMid:15031238; PMCid:PMC381222
Healey, F., Monro, A., Cockram, A., Adams, V. & Heseltine, D., 2004. Using targeted risk factor reduction to prevent falls in older in-patients: a randomised controlled trial. Age and Ageing, 33(4), pp. 390-395. http://dx.doi.org/10.1093/ageing/afh130, PMid:15151914
Heart & Stroke Foundation, 2013. Canadian best practice recommendations for stroke care. stroke rehabilitation. Available at: http://www.strokebestpractices.ca [17. 4. 2014].
Kwok, T., Mok, F., Chien, W.T. & Tam, E., 2006. Does access to bed-chair pressure sensors reduce physical restraint use in the rehabilitative care setting? Journal Clinical Nursing, 15(5), pp. 581-587. http://dx.doi.org/10.1111/j.1365-2702.2006.01354.x, PMid:16629967
Lamb, S.E., Ferruci, L., Volapto, S., Fried, L.P. & Guralnik, J.M., 2003. Risk factors for falling in home-dwelling older women with stroke. Stroke, 34(2), pp. 495-501. http://dx.doi.org/10.1161/01.STR.0000053444.00582.B7
Marigold, D.S., Eng, J.J., Dawson, A.S., Inglis, J.T., Harris, J.E. & Gylfadottir, S., 2005. Exercise leads to faster postural reflexes, improved balance and mobility, and fewer falls in older persons with chronic stroke. Journal of American Geriatric Society, 53(3), pp. 416-423. http://dx.doi.org/10.1111/j.1532-5415.2005.53158.x, PMid:15743283; PMCid:PMC3226796
Marolt, M. & Goljar, N., 2008. Padci pri bolnikih po možganski kapi na oddelku za rehabilitacijo. Rehabilitacija, 7(2), pp. 17-22.
Meyer, G., Kopke, S., Haastert, B. & Muhlhauser, I., 2009. Comparison of a fall risk assessment tool with nursesˈ judgement alone: a cluster - randomised controlled trial. Age and Ageing, 38(4), pp. 417-423. http://dx.doi.org/10.1093/ageing/afp049, PMid:19435759
Morse, J.M., 2009. Preventing patient falls: establishing a fall intervention program. 2nd ed. New York: Springer, p. 6.
Nakagawa, Y., Sannomiya, K. & Kinoshita, M., 2008. Development of an assessment sheet for fall prediction in stroke inpatients in convalescent rehabilitation wards in Japan. Environmetal Health and Preventive Medicine, 13(3), pp. 138-147. http://dx.doi.org/10.1007/s12199-007-0023-8, PMid:19568898; PMCid:PMC2698258
National Stroke Foundation, 2010. Clinical Guidelines for Stroke Management. Available at: http://www.nhmrc.gov.au/guidelines/publications/cp126 [17. 4. 2014].
Oliver, D., 2008. Falls risk prediction tools for hospital inpatients. Time to put them to bed? Age and Ageing, 37(3), pp. 248-250. http://dx.doi.org/10.1093/ageing/afn088, PMid:18456789
Sato, Y., Iwamoto, J., Kanoko, T. & Satoh, K., 2005. Low-dose vitamin D prevents muscular atrophy and reduces falls and hip fractures in women after stroke: a randomized controlled trial. Cerebrovascular Diseases, 20(3), pp. 187-192. http://dx.doi.org/10.1159/000087203, PMid:16088114
Stenvall, M., Olofsson, B., Lundström, M., Englund, U., Borssén, B., Svensson, O., et al., 2007. A multidisciplinary, multifactorial intervention program reduces postoperative falls and injuries after femoral neck fracture. Osteoporos International, 18(2), pp. 167-175.
http://dx.doi.org/10.1007/s00198-006-0226-7, PMid:17061151; PMCid:PMC1766476
Strokovno poročilo Inštituta Republike Slovenije za rehabilitacijo za leto 2007, 2008. [2008]. Ljubljana: Inštitut Republike Slovenije za rehabilitacijo, pp. 6-8.
Strokovno poročilo Inštituta Republike Slovenije za rehabilitacijo za leto 2008, [2009]. Ljubljana: Inštitut Republike Slovenije za rehabilitacijo, pp. 8-10.
Strokovno poročilo za leto 2009 za JZZ Univerzitetni rehabilitacijski inštitut Republike Slovenije- Soča, [2010]. Ljubljana: Univerzitetni rehabilitacijski inštitut Republike Slovenije- Soča, pp. 11-18.
Strokovno poročilo za leto 2010 za JZZ Univerzitetni rehabilitacijski inštitut Republike Slovenije- Soča, [2011]. Ljubljana: Univerzitetni rehabilitacijski inštitut Republike Slovenije- Soča, pp. 11-20.
Strokovno poročilo za leto 2011 za JZZ Univerzitetni rehabilitacijski inštitut Republike Slovenije- Soča, [2012]. Ljubljana: Univerzitetni rehabilitacijski inštitut Republike Slovenije- Soča, pp. 11-20.
Strokovno poročilo za leto 2012 za JZZ Univerzitetni rehabilitacijski inštitut Republike Slovenije - Soča, [2013]. Ljubljana: Univerzitetni rehabilitacijski inštitut Republike Slovenije- Soča, pp. 11-24.
Suzuki, T., Sonoda, S. & Misawa, K., 2005. Incidence and consequence of falls in inpatient rehabilitacion of stroke patients. Experimental Aging Research, 31(4), pp. 457-469.
http://dx.doi.org/10.1080/03610730500206881; PMid:16147463
Šavli, J. & Trtnik, R., 2010. Analiza padcev pacientov po možganski kapi s stališča medicinske sestre. In: Petkovšek-Gregorin, R. ed. Varnost in rehabilitacijska zdravstvena nega: zbornik predavanj, Ljubljana, 15. april 2010. Ljubljana: Zbornica zdravstvene in babiške nege Slovenije - Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije, Sekcija medicinskih sester in zdravstvenih tehnikov v rehabilitaciji in zdraviliški dejavnosti, 2010, pp. 53-58.
Vassallo, M., Sharma, J.C., Briggs, R.S. & Allen, S.C., 2003. Characteristics of early fallers on elderly patient rehabilitation wards. Age and Ageing, 32(3), pp. 338-42. http://dx.doi.org/10.1093/ageing/32.3.338, PMid:12720623
Vodušek, D.B., 1992. Višja živčna dejavnost. Medicinski Razgledi, 31(3), pp. 369-400.
Vrabič, M., 2011. Padci pacientov, hospitaliziranih v Univerzitetnem rehabilitacijskem inštitutu Republike Slovenije- vidik zdravstvenih delavcev. Obzornik zdravstvene nege, 45(1), pp. 55–60.
Zakon o duševnem zdravju (ZDZdr), 2008. Uradni list Republike Slovenije št. 77.
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