A retrospective study to identify unique contributors to falls in hospitalized adult hematology patients

Abstract

A fall may be defined as an event that results in a person coming to rest inadvertently on a lower level surface or an unplanned descent to the floor with or without injury. Fall prevention is a concept associated with hindering a fall from happening through advance care planning or action. The body of knowledge on falls, risk factors, consequences, and prevention originates from studies of older persons who have experienced a fall. The medical community has made several efforts toward fall risk assessment with an emphasis on prevention of the reoccurrence of falls, but this approach could potentially skew attention away from initial fall prevention efforts. The purpose of this retrospective case-control study was to identify unique contributors to falls in hospitalized adult cancer patients with a hematologic diagnosis. Falls in this population are a great safety concern for nurses and other healthcare providers. Patients with hematologic disorders are at an increased risk of sustaining an injury due to their low platelet counts resulting from chemotherapy and radiation treatments. Patient falls, and patient falls with injury are healthcare outcome measures that are currently being used to evaluate the quality of hospital nursing care, and are an integral part of the National Database of Nursing Quality Indicators (NDNQI). The Centers for Medicare and Medicaid Services no longer reimburses hospitals for in-hospital falls with injury, therefore, placing a greater burden on nursing staff to ensure patient safety through the development of nurse-driven fall prevention strategies, and the implementation of risk reduction plans of care. A total of 94 electronic medical records, which served as the primary sources of data were reviewed in this study and data on ten independent variables and one dependent variable were analyzed. Simple logistic regression between continuous variables and one dependent variable, and cross-tabulation between categorical variables and the dependent variable was used to analyze study results. Stepwise logistic regression was utilized for the final analysis of data. The relationship between fall incident and fall risk assessment score on admission was significant, X2 (1) = 6.153, p<.013, Cramer’s V = .256. Additional research is planned for generalizability.