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Machado-Duque ME, Camacho-Arteaga L, Sabaté M, Machado-Alba JE. Falls in older adults hospitalized in tertiary centers in Colombia. Clinical description and complications. ENFERMERIA CLINICA (ENGLISH EDITION) 2024:S2445-1479(24)00064-X. [PMID: 38964715 DOI: 10.1016/j.enfcle.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 07/06/2024]
Abstract
OBJECTIVE The incidence of falls in elderly patients in the hospital environment is three times higher than that in the community. The aim was to determine the characteristics of patients who suffered in-hospital falls and their complications. METHODS This was a cross-sectional study with patients older than 64 years of age, admitted between 2018 and 2020 to four clinics in Colombia who presented a fall during their stay. Clinical data, reasons for the fall, complications and use of drugs with a known risk for causing falls and with an anticholinergic load were reviewed. RESULTS A total of 249 patients were included. The mean age was 77.5 ± 7.4 years, and there was a predominance of males (63.9%). The patients were hospitalized mainly for community-acquired pneumonia (12.4%) and heart failure (10.4%). Falls occurred most frequently in hospitalization wards (77.1%) and emergency departments (20.9%). Falls were related to standing alone (34.4%) and on the way to the bathroom (28.9%), with 40.6% (n = 102) of falls resulting in trauma, especially to the head (27.7%); the incidence of fractures was low (3.2%). Ninety-two percent of patients had polypharmacy (≥5 drugs), 88.0% received psychotropic drugs, and 37.3% received drugs with an anticholinergic load ≥3 points. CONCLUSIONS Hospitalized adults over 65 years of age suffered falls, mainly in hospitalization wards and emergency departments, especially during the process of solitary ambulation. Most had received psychotropic drugs and medications with a high anticholinergic load. These results suggest that it is necessary to improve risk prevention strategies for falls in this population.
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Affiliation(s)
- Manuel E Machado-Duque
- Departamento de Farmacología, Terapéutica y Toxicología, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma SA, Pereira, Risaralda, Colombia; Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia
| | - Lina Camacho-Arteaga
- Departamento de Farmacología, Terapéutica y Toxicología, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; Departamento de Farmacología Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Grupo de Investigación en Farmacología Clínica, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Mónica Sabaté
- Departamento de Farmacología, Terapéutica y Toxicología, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; Departamento de Farmacología Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Grupo de Investigación en Farmacología Clínica, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Jorge E Machado-Alba
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma SA, Pereira, Risaralda, Colombia.
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Kim J, Lee E, Jung Y, Kwon H, Lee S. Patient-level and organizational-level factors influencing in-hospital falls. J Adv Nurs 2022; 78:3641-3651. [PMID: 35441709 PMCID: PMC9790490 DOI: 10.1111/jan.15254] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/24/2022] [Accepted: 03/23/2022] [Indexed: 12/30/2022]
Abstract
AIM In-hospital fall is one key safety issue in a healthcare setting. Although healthcare providers apply several strategies for preventing falls, falls still occur in hospitals. The aim of this study was to investigate patient-level and organizational-level factors influencing in-hospital falls. DESIGN A multicentre retrospective observational study. METHODS This study used the national healthcare database and supplemented with organizational data obtained through a survey. Data extraction and survey were conducted between July and August 2020. A mixed-effect logistic regression model was used to analyse factors influencing in in-hospital falls. RESULTS A total of 43,286 patients admitted in 86 hospitals were included in this study. Fall rate was 0.85 per 1000 days. Length of stay was significantly longer for fall patients than for no-fall patients. Patient-level factors (including age, mobility impairment and surgery) and organizational-level factors (including nurse staffing and proportion of new nurses) were significant factors influencing in-hospital falls. CONCLUSION Since in-hospital falls increase economic burden to patients, we should consider various fall prevention strategies to reduce falls. For a strategy to be applied stably to patients, organizational factors must be supported. IMPACT Proactive fall management in acute settings is essential to ensure patient safety. Considering that the number of patients with fall risk is increasing due to ageing, organizational factors should be supported to provide quality nursing care for fall risk patients. Therefore, nurse leaders should primarily ensure an appropriate level of nurse staffing. They also need to make efforts to strengthen clinical competency of nurses.
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Affiliation(s)
- Jinhyun Kim
- College of NursingSeoul National UniversitySeoulSouth Korea
| | - Eunhee Lee
- School of Nursing/Research Institute of Nursing ScienceHallym UniversityChuncheonGangwon‐doSouth Korea
| | - Yoomi Jung
- Korea Armed Forces Nursing AcademyDaejeonSouth Korea
| | - Hyunjeong Kwon
- College of NursingSeoul National UniversitySeoulSouth Korea
| | - Sunmi Lee
- College of NursingSeoul National UniversitySeoulSouth Korea
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Imam A, Obiesie S, Aluvaala J, Maina JM, Gathara D, English M. Identifying gaps in global evidence for nurse staffing and patient care outcomes research in low/middle-income countries: an umbrella review. BMJ Open 2022; 12:e064050. [PMID: 36223964 PMCID: PMC9562716 DOI: 10.1136/bmjopen-2022-064050] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To identify nurse staffing and patient care outcome literature in published systematic reviews and map out the evidence gaps for low/middle-income countries (LMICs). METHODS We included quantitative systematic reviews on nurse staffing levels and patient care outcomes in regular ward settings published in English. We excluded qualitative reviews or reviews on nursing skill mix. We searched the Cochrane Register of Systematic Reviews, the Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports, Medline, Embase and Cumulative Index to Nursing and Allied Health Literature from inception until July 2021. We used the A Measurement Tool to Assess Systematic Reviews -2 (AMSTAR-2) criteria for risk of bias assessment and conducted a narrative synthesis. RESULTS From 843 papers, we included 14 in our final synthesis. There were overlaps in primary studies summarised across reviews, but overall, the reviews summarised 136 unique primary articles. Only 4 out of 14 reviews had data on LMIC publications and only 9 (6.6%) of 136 unique primary articles were conducted in LMICs. Only 8 of 23 patient care outcomes were reported from LMICs. Less research was conducted in contexts with staffing levels that are typical of many LMIC contexts. DISCUSSION Our umbrella review identified very limited data for nurse staffing and patient care outcomes in LMICs. We also identified data from high-income countries might not be good proxies for LMICs as staffing levels where this research was conducted had comparatively better staffing levels than the few LMIC studies. This highlights a critical need for the conduct of nurse staffing research in LMIC contexts. LIMITATIONS We included data on systematic reviews that scored low on our risk of bias assessment because we sought to provide a broad description of the research area. We only considered systematic reviews published in English and did not include any qualitative reviews in our synthesis. PROSPERO REGISTRATION NUMBER CRD42021286908.
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Affiliation(s)
- Abdulazeez Imam
- Health Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Sopuruchukwu Obiesie
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Jalemba Aluvaala
- Health Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | | | - David Gathara
- Wellcome Trust Research Program, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Centre for Maternal Adolescent Reproductive and Child Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Mike English
- Health Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Yang W, Liu Y, Zeng T, Wang Y, Hao X, Yang W, Wang H. Research focus and thematic trends in magnet hospital research: A bibliometric analysis of the global publications. J Adv Nurs 2021; 77:2012-2025. [PMID: 33450072 DOI: 10.1111/jan.14757] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 11/22/2020] [Accepted: 12/16/2020] [Indexed: 12/16/2022]
Abstract
AIMS The study aims to carry out a bibliometric analysis of the research on magnet hospital from 1988-2020. DESIGN A statistical and visualization bibliometric analysis was conducted between February-May 2020. METHODS The information was extracted from Web of Science by the topic advanced search strategy. HistCite-Pro, Excel, GunnMap, BibExcel and VOSviewer were used to extract, integrate and visualize the bibliometric information. Furthermore, the research contents of the core-authors were explored and summarized by reviewing all the published articles. RESULTS Articles (N = 396) published in 107 journals were retrieved in the Web of Science from 1988-2020. The USA (N = 319) and University of Pennsylvania (N = 38) were the most productive country and institution respectively. Author co-citation and bibliographic-coupling network analysis identified that Aiken, Kramer, Laschinger, Schmalenberg, Lake and Johantgen were the major contributors and leaders in this field. According to the research content of the main contributors and keyword co-occurrence analysis result, the research focus could be divided into four parts: the mechanism leading to the outcomes differences for magnet hospital, the evidence-based practice, the outcomes comparison between magnet hospital and non-magnet hospital and the practice environment. CONCLUSION This bibliometric study offered a comprehensive overview of current study status of magnet hospital and this area has been drawn increasing attention over the years. However, the research on magnet hospital is still relative limited and needs to be paid more attention, especially in developing countries. IMPACT This study showed the most contributed countries, journals, institutions, authors and the main themes related to magnet hospital, which would help researchers find potential partners, optimize and deepen future research, such as enhancing the magnet hospital research in developing countries, improving the evidence-based research and considering the impact caused by different culture. Furthermore, this study can also give suggestions for magnet hospital policy makers.
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Affiliation(s)
- Weimei Yang
- Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Liu
- Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tieying Zeng
- Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ying Wang
- Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinying Hao
- School of Humanities and Social Sciences, University of Science and Technology of China, Hefei, China
| | - Weiqiang Yang
- National Engineering Laboratory for Electric Vehicles, Beijing Institute of Technology, Beijing, China
| | - Hui Wang
- Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Kim IJ. Hospital flooring safety and health: knowledge gaps and suggestions. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2020; 27:1116-1135. [PMID: 31679473 DOI: 10.1080/10803548.2019.1688473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Fall incidents are a leading safety concern in the hospital industry. Whereas roughening the floor surface can reduce fall risks, there remains unanswered controversies between achieving and maintaining hygienic cleaning efficiencies and adequately addressing conditions of flooring safety. Thus, the current study critically overviews the status of research and accepted practices on hospital flooring safety and healthy controls. Salient literature was identified by searching keywords and phrases within the databases of PubMed, Web of Science, MEDLINE, Scopus and ScienceDirect to find answers for the major questions on hospital floorings. A comprehensive review analysis identified that underlying causes of hospital fall incidents and flooring-attributable infectious illnesses mainly comprised floor types and materials, cleaning chemicals, materials and methods, maintenance and slip-resistance properties. Findings from this study suggest several major actions to advance hospital flooring safety and health research and practice.
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Affiliation(s)
- In-Ju Kim
- College of Engineering, University of Sharjah, United Arab Emirates
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Abstract
BACKGROUND The Humpty Dumpty Falls Prevention Program was developed to address an unmet need to identify pediatric patients at risk of a fall event. PURPOSE The aim of this study was to evaluate the performance of the Humpty Dumpty Fall Scale-Inpatient (HDFS) across a diverse, international pediatric population. In addition, the characteristics of patients who experienced a fall were analyzed. METHODS A retrospective, cross-sectional design was used to assess fall risk across 16 hospitals and 2238 pediatric patients. Multiple and simple logistic regressions were performed to evaluate association of individual scale items and total score with falls during hospitalization. Reliability, sensitivity, and specificity of the HDFS were also assessed. RESULTS Several of the HDFS items were significantly associated with the risk of falls in the pediatric population, but specificity of the tool is a concern to consider for future tool enhancement. CONCLUSIONS Characteristics for further refinement of the HDFS were identified.
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Shin S, Park J, Bae S. Nurse staffing and hospital‐acquired conditions: A systematic review. J Clin Nurs 2019; 28:4264-4275. [DOI: 10.1111/jocn.15046] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/29/2019] [Accepted: 08/18/2019] [Indexed: 02/02/2023]
Affiliation(s)
- Sujin Shin
- College of Nursing Ewha Womans University Seoul Korea
| | - Jin‐Hwa Park
- College of Nursing Daegu Catholic University Daegu Korea
| | - Sung‐Heui Bae
- College of Nursing Ewha Womans University Seoul Korea
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Kim J, Kim S, Park J, Lee E. Multilevel factors influencing falls of patients in hospital: The impact of nurse staffing. J Nurs Manag 2019; 27:1011-1019. [PMID: 30844102 DOI: 10.1111/jonm.12765] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/06/2019] [Accepted: 03/03/2019] [Indexed: 12/01/2022]
Abstract
AIM The objective of this study was to investigate both individual and organizational factors influencing the falls of patients in hospitals. BACKGROUND Falls and fall-related injuries, which cause health problems and increase the economic burden to patients, are a critical issue for patient safety. METHODS This study retrospectively reviewed patient data and analysed factors influencing patient falls using a mixed-effect model. RESULTS The total number of patients in the study was 60,049, and the characteristics of the patients showed statistically significant differences according to the type of hospital where the fall occurred. The average rate of falls was 0.92 per 1,000 days. The rate of falls in general hospitals was the highest among all hospitals. Age, mobility impairment and hours per patient day for care delivered by registered nurses were factors influencing patients' falls. CONCLUSION Since the number of patient falls in an acute-care setting might increase in the future because of the growing elderly population, we should consider these risk factors for falls and construct preventative programs accordingly. IMPLICATIONS FOR NURSING MANAGEMENT An adequate level of nursing staff is an essential factor in the number of patient falls.
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Affiliation(s)
- Jinhyun Kim
- College of Nursing, Seoul National University, Seoul, Korea
| | - Sungjae Kim
- College of Nursing, Seoul National University, Seoul, Korea
| | - Jinhee Park
- College of Nursing, Seoul National University, Seoul, Korea
| | - Eunhee Lee
- School of Nursing/Research Institute of Nursing Science, Hallym University, Chuncheon, Korea
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Tucker S, Sheikholeslami D, Farrington M, Picone D, Johnson J, Matthews G, Evans R, Gould R, Bohlken D, Comried L, Petrulevich K, Perkhounkova E, Cullen L. Patient, Nurse, and Organizational Factors That Influence Evidence‐Based Fall Prevention for Hospitalized Oncology Patients: An Exploratory Study. Worldviews Evid Based Nurs 2019; 16:111-120. [DOI: 10.1111/wvn.12353] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Sharon Tucker
- Translational Research CoreHelene Fuld Health Trust National Institute for EBP in Nursing & HealthcareCollege of NursingThe Ohio State University Columbus OH USA
| | - Deborah Sheikholeslami
- Medical Surgical Nursing DivisionDepartment of Nursing Services and Patient CareUniversity of Iowa Hospitals and Clinics Iowa City IA USA
| | - Michele Farrington
- Office of Nursing Research andEvidence‐Based PracticeDepartment of Nursing Services and Patient CareUniversity of Iowa Hospitals and Clinics Iowa City IA USA
| | - Debra Picone
- Office of Clinical Quality, Safety and Performance ImprovementUniversity of Iowa Hospitals and Clinics Iowa City IA USA
| | - Janis Johnson
- Medical Surgical Nursing DivisionDepartment of Nursing Services and Patient CareUniversity of Iowa Hospitals and Clinics Iowa City IA USA
| | - Grace Matthews
- Medical Surgical Nursing DivisionDepartment of Nursing Services and Patient CareUniversity of Iowa Hospitals and Clinics Iowa City IA USA
| | - Rhonda Evans
- Medical Surgical Nursing DivisionDepartment of Nursing Services and Patient CareUniversity of Iowa Hospitals and Clinics Iowa City IA USA
| | - Renee Gould
- Office of Nursing ResearchEvidence‐Based Practice and QualityDepartment of Nursing Services and Patient CareUniversity of Iowa Hospitals and Clinics Iowa City IA USA
| | - Deborah Bohlken
- Department of Nursing Services and Patient CareUniversity of Iowa Hospitals and Clinics Iowa City IA USA
| | - Lynn Comried
- Department of Nursing Services and Patient CareUniversity of Iowa Hospitals and Clinics Iowa City IA USA
| | - Kelly Petrulevich
- Department of Nursing Services and Patient CareUniversity of Iowa Hospitals and Clinics Iowa City IA USA
| | | | - Laura Cullen
- Office of Nursing Research andEvidence‐Based PracticeDepartment of Nursing Services and Patient CareUniversity of Iowa Hospitals and Clinics Iowa City IA USA
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An Analysis of Falls and Those who Fall in a Chronic Care Facility. J Am Med Dir Assoc 2019; 20:171-176. [DOI: 10.1016/j.jamda.2018.06.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 06/22/2018] [Accepted: 06/26/2018] [Indexed: 11/19/2022]
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Bowden V, Bradas C, McNett M. Impact of level of nurse experience on falls in medical surgical units. J Nurs Manag 2019; 27:833-839. [DOI: 10.1111/jonm.12742] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 11/19/2018] [Accepted: 12/13/2018] [Indexed: 11/28/2022]
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The Relationship Between Magnet Designation, Electronic Health Record Adoption, and Medicare Meaningful Use Payments. Comput Inform Nurs 2017; 35:385-391. [PMID: 28252514 DOI: 10.1097/cin.0000000000000336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The objective of this study was to examine the relationship between nursing excellence and electronic health record adoption. Of 6582 US hospitals, 4939 were eligible for the Medicare Electronic Health Record Incentive Program, and 6419 were eligible for evaluation on the HIMSS Analytics Electronic Medical Record Adoption Model. Of 399 Magnet hospitals, 330 were eligible for the Medicare Electronic Health Record Incentive Program, and 393 were eligible for evaluation in the HIMSS Analytics Electronic Medical Record Adoption Model. Meaningful use attestation was defined as receipt of a Medicare Electronic Health Record Incentive Program payment. The adoption electronic health record was defined as Level 6 and/or 7 on the HIMSS Analytics Electronic Medical Record Adoption Model. Logistic regression showed that Magnet-designated hospitals were more likely attest to Meaningful Use than non-Magnet hospitals (odds ratio = 3.58, P < .001) and were more likely to adopt electronic health records than non-Magnet hospitals (Level 6 only: odds ratio = 3.68, P < .001; Level 6 or 7: odds ratio = 4.02, P < .001). This study suggested a positive relationship between Magnet status and electronic health record use, which involves earning financial incentives for successful adoption. Continued investigation is needed to examine the relationships between the quality of nursing care, electronic health record usage, financial implications, and patient outcomes.
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Fehlberg EA, Lucero RJ, Weaver MT, McDaniel AM, Chandler AM, Richey PA, Mion LC, Shorr RI. Associations between hyponatraemia, volume depletion and the risk of falls in US hospitalised patients: a case-control study. BMJ Open 2017; 7:e017045. [PMID: 28790043 PMCID: PMC5724091 DOI: 10.1136/bmjopen-2017-017045] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE We aimed to determine if abnormal laboratory values which may indicate volume depletion are associated with increased odds of experiencing a hospital-acquired fall. DESIGN Matched case-control study. SETTING Four hospitals located in the Southeast USA. PARTICIPANTS Data from 699 adult fallers and 1189 matched controls (non-fallers) were collected via chart review from 2005 to 2010. Controls were matched to cases by nursing unit, time of fall and length of stay. OUTCOME MEASURES The primary exposures included serum sodium, blood urea nitrogen (BUN), creatinine, BUN/creatinine ratio and haematocrit. Conditional logistic regression with m:n matching was used to determine adjusted and unadjusted ORs. RESULTS Serum sodium levels were strongly associated with falls. In models controlling for demographic and other fall risk factors, patients with serum sodium levels of 125 mEq/L or less were associated with increased odds of experiencing a fall as compared with those with serum sodium levels of greater than 134 mEq/L (adjusted OR (aOR)=5.08, 95% CI 1.43 to 18.08). Conversely, elevated BUN, creatinine and elevated BUN/creatinine ratios were not associated with increased odds of experiencing a fall (aOR=0.64, 95% CI 0.49 to 0.84; aOR=0.70, 95% CI 0.54 to 0.92 and aOR=0.77, 95% CI 0.58 to 1.04, respectively.) CONCLUSIONS: Laboratory indices that may indicate volume depletion appear to be unrelated to falls. However, hyponatraemia does appear to be a risk factor for falls, and those with serum sodium levels below 126 mEq/L are at especially high risk. It may be that other deficits associated with hyponatraemia, like altered mental status, are associated with risk of experiencing a hospital-acquired fall. These results indicate that abnormal laboratory values, like low sodium, can be useful for identifying hospitalised patients at risk of falling. Therefore, further investigation into abnormal laboratory values as predictors of hospital-acquired falls is warranted.
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Affiliation(s)
- Elizabeth A Fehlberg
- Departments of Biobehavioral Nursing and Family, Community, and Health System Science, University of Florida College of Nursing, Gainesville, Florida, USA
- Clinical and Translational Science Institute, University of Florida, Gainesville, Florida, USA
- Division of Research on Healthcare Value, Equity, and the Lifespan, RTI International, Research Triangle Park, NC, USA
| | - Robert J Lucero
- Departments of Biobehavioral Nursing and Family, Community, and Health System Science, University of Florida College of Nursing, Gainesville, Florida, USA
- Clinical and Translational Science Institute, University of Florida, Gainesville, Florida, USA
- Center for Innovation on Disability and Rehabilitation Research (CINDRR), Malcom Randall VAMC, Gainesville, Florida, USA
| | - Michael T Weaver
- Departments of Biobehavioral Nursing and Family, Community, and Health System Science, University of Florida College of Nursing, Gainesville, Florida, USA
| | - Anna M McDaniel
- Departments of Biobehavioral Nursing and Family, Community, and Health System Science, University of Florida College of Nursing, Gainesville, Florida, USA
| | | | - Phyllis A Richey
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Lorraine C Mion
- Center of Excellence in Critical and Complex Care, The Ohio State University College of Nursing, Columbus, Ohio, USA
| | - Ronald I Shorr
- Clinical and Translational Science Institute, University of Florida, Gainesville, Florida, USA
- Geriatric Research Education and Clinical Centers (GRECC), Malcom Randall VAMC, Gainesville, Florida, USA
- Department of Epidemiology, University of Florida, Gainesville, Florida, USA
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Características de la escala Downton en la valoración del riesgo de caídas en pacientes hospitalizados. ENFERMERIA CLINICA 2017; 27:227-234. [DOI: 10.1016/j.enfcli.2017.02.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 01/03/2017] [Accepted: 02/25/2017] [Indexed: 11/19/2022]
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Weil TP. Patient falls in hospitals: An increasing problem. Geriatr Nurs 2015; 36:342-7. [DOI: 10.1016/j.gerinurse.2015.07.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 07/08/2015] [Accepted: 07/13/2015] [Indexed: 10/23/2022]
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AL-Rawajfah OM, Aloush S, Hewitt JB. Use of Electronic Health-Related Datasets in Nursing and Health-Related Research. West J Nurs Res 2014; 37:952-83. [DOI: 10.1177/0193945914558426] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Datasets of gigabyte size are common in medical sciences. There is increasing consensus that significant untapped knowledge lies hidden in these large datasets. This review article aims to discuss Electronic Health-Related Datasets (EHRDs) in terms of types, features, advantages, limitations, and possible use in nursing and health-related research. Major scientific databases, MEDLINE, ScienceDirect, and Scopus, were searched for studies or review articles regarding using EHRDs in research. A total number of 442 articles were located. After application of study inclusion criteria, 113 articles were included in the final review. EHRDs were categorized into Electronic Administrative Health-Related Datasets and Electronic Clinical Health-Related Datasets. Subcategories of each major category were identified. EHRDs are invaluable assets for nursing the health-related research. Advanced research skills such as using analytical softwares, advanced statistical procedures, dealing with missing data and missing variables will maximize the efficient utilization of EHRDs in research.
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