Patient Falls in Hospital
- 1. Data derived fromvariety of sources such as WHO, EuroSafe, Eurostat, and other secondary sources, may account for some statistical discrepancies. Topic: Patient Falls in Hospitals 1. Fall-Related Injuries: Fall is an event/accident which results in an individual coming to rest inadvertently on the ground/floor/other lower level. Falls are prominent among the external causes of unintentional injury. Fig 1.: Patient Falls Causes: Interaction of Ageing, Environment, and Disease 1.1. Average Stays in Hospitals The below chart shows the average day of inpatients in hospitals in the European Union (EU). The duration of hospital stay increases the risk of fall-related injuries in hospitals. Fig 2.: Average Stays in Hospitals Note: Top 10 EU countries are considered Source: Eurostat 1.2. Fall-related injuries statistics Age and gender associated with functional decline and impairment result in an increased risk of fall-related injuries. Falls costs are high; both to the individual, careers, and society. According to EuroSafe, among the 36,000 (approx. figure) fall-related deaths among older adults: • 88% relate to people aged 75 or more • 59% relate to women It is expected that the population of elder people (65+) in the EU to grow by 60% by 2050. In addition, the number of fall- related deaths is projected to surge to almost 60,000 by 2050. Fig 3.: Patient Falls in Hospitals, By Age and Gender – 2014 Note: Numbers are assumed based on the percentage of fall-related injuries that occurred in Hospitals in EU countries Source: EuroSafe 1.3. Expenditure: Costs for Fall-related Injury It is estimated that the healthcare expenditure for treating fall- related injuries in the EU, is at least 25 billion Euros annually. Moreover, a shift in demographics over the next 25 – 35 years may result in annual fall-related costs exceeding 45 Billion Euros by 2050. Table 1.: Average Medical and Social Care Costs for fall- related Injury Age-Group Average Annual Cost, Euro/Case 65 – 70 ~4,000 85+ ~14,000 Average Cost Annually ~9,500 Source: WHO, EuroSafe 2. Causes of Patient Falls in Hospital Fig 3.: Risk Factors or Causes of Patient Falls in Hospital Source: Secondary Research Ageing Acute Illness Chronic Disease Social Vulnerability 0 1 2 3 4 5 6 7 8 9 10 Czech Republic Hungray Croatia France Germany Luxembourg Finland Switzerland Austria Italy Average Number of Days 2016 Average Length of Stay for Hospital In-Patient, EuropeanCountries 0 50,000 100,000 150,000 200,000 250,000 0-14 Years 15-24 Years 25-64 Years 65+ Years Fatal Injuries Injury Admissions 0 50,000 100,000 150,000 200,000 250,000 300,000 Male Female Riskfactor model for fallsin Hospital Environmental Risk • Poor buildingdesign • Slippery floors & stairs • Equipment in rooms & hallwaysthatgets in way • Insufficientlightening • Uneven sidewalks Biological Risk • Age and Gender • Chronic illness (Arthritis, Osteoporosis, etc.) • Physical, cognitive and affective capacities decline Behavioural Risk • Multiplemedication use • Lack of exercise • Mental and behavioural disorders • Inappropriatefoot ware Socioeconomic Risk • Lack off social interactions • Education and income level
- 2. Data derived fromvariety of sources such as WHO, EuroSafe, Eurostat, and other secondary sources, may account for some statistical discrepancies. As per WHO, the frequency of falls primarily depends on age and gender. To quantify this, the below table shows the magnitude of falls in different age groups yearly. The frequency of falls increases with age and frailty level. Out of the total falls, 8% – 10% of fall-related injuries occur in Hospitals. Elder people in hospitals or nursing homes fall more often than those who are living in the community. Approximately 30% – 50% of people living in hospitals (care institutions) fall each year, and 40% of them experienced recurrent falls. Table 2.: Magnitude of Falls Age Group Frequency Increase in Fall Rate 65 – 70 28% – 35% 2% – 4% 70 – Above 32% – 42% 5% – 7% Source: WHO 2.1. Challenges of an aging population and rising emergency admission Nearly 2/3 of patients admitted to hospitals are over 60 and many have dementia, frailty, or complex needs. The below figure shows the daily activities which may result in patient falls after admission to hospitals. Source: Secondary Research Fig. 4.: Patient Fall-Related Injuries across Europe Source: WHO, EuroSafe, and other Secondary Research The injury pyramid figure narrates the fall-related injuries among 65+ age people in 2012. Out of which 8% – 10% of fall-related injuries occur in Hospitals only. Fig. 5.: Injury Pyramid for Falls in Europe Note: Above data shows the figure of 2012 for EU–28 Source: EuroSafe, and other Secondary Research 3. Fall Prevention • Creating awareness about the importance of falls prevention • Improving the identification and assessment of risk factors and factors of falls • Identifying and implementing realistic and effective interventions The below figure illustrates the fall prevention model Fig. 6.: Fall Prevention Model Source: WHO and Secondary Research Apart from this, a large number of companies are developing various medical devices and products to help patient to prevent falls. Medical devices which can prevent patient falls in hospitals include Fall mats, low beds, total lift beds, fall risk kits, belts, alarms, sensors, toilet lift, etc. Reasons for Hospital Injuries Bathing Dressing Mobility Transfers Toileting Eating 50% 23% 11% 4% 4% 8% Type of Injury Fracture Contusion, Bruise Open Wound Sprain, Strain Concussion, Brain Injury Others 36% 30% 19% 10% 5% Body Part Affected Upper Extremitiees Lower Extremities Head Body Others 36,000 Fatal injury to old people 1,443,000 Fall-related injuries 2,314,000Admittedto emergency departmentwith fall-related injuries A w a r e n e s s •Elderly Persons •Youth •Community •Health Sector •Media •Government •Family or Caregivers A s s e s s m e n t •Community and individual risk determinants •Health and social services •Behavioural •Personal •Physical environments •Social •Economics I n t e r v e n t i o n •Behaviour change •Individual level •Environmental level •Health and social services level Falls Prevention for Active Ageing H e a l t h y P u b l i c P o l i c y G e n d e r C u l t u r e Education Capacity Building Training Community Surveillance Resources Research
- 3. Data derived fromvariety of sources such as WHO, EuroSafe, Eurostat, and other secondary sources, may account for some statistical discrepancies. Some of the leading companies manufacturing medical devices are Medline Industries, Alimed Inc., Posey Products, Agiliti Health Inc., Hill–Rom Services, STANLEY Healthcare, among others.