Reducing serious fall-related injuries in acute hospitals: are low-low beds a critical success factor?

Authors

  • Anna Barker,

    1. Anna Barker PhD BPhty MPhty
      Senior Research Fellow
      Centre of Research Excellence in Patient Safety, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
      and
      Northern Clinical Research Centre, The Northern Hospital, Epping, Victoria, Australia
    Search for more papers by this author
  • Jeannette Kamar,

    1. Jeannette Kamar BAppSc (Nsg) GradCert (Psych Nurs)
      Injury Prevention/Falls Coordinator
      Injury Prevention Unit, The Northern Hospital, Epping, Victoria, Australia
    Search for more papers by this author
  • Tamara Tyndall,

    1. Tamara Tyndall BAppSc (Nsg)
      Injury Prevention Nurse
      Injury Prevention Unit, The Northern Hospital, Epping, Victoria, Australia
    Search for more papers by this author
  • Keith Hill

    1. Keith Hill BAppSc(Physio) PhD
      Professor/Head of School School of Physiotherapy, Curtin University, Perth, Western Australia
      and
      Preventive and Public Health Division, National Ageing Research Institute, Parkville, Victoria, Australia
    Search for more papers by this author

A.L. Barker: e-mail: anna.barker@monash.edu.au and J. Kamar: e-mail: jeanette.kamar@nh.org.au

Abstract

Aim.  This article is a report of a study of associations between occurrence of serious fall-related injuries and implementation of low-low beds at The Northern Hospital, Victoria, Australia.

Background.  A 9-year evaluation at The Northern Hospital found an important reduction in fall-related injuries after the 6-PACK falls prevention program was implemented. Low-low beds are a key component of the 6-PACK that aims to decrease fall-related injuries.

Design.  A retrospective cohort study.

Methods.  Retrospective audit of The Northern Hospital inpatients admitted between 1999–2009. Changes in serious fall-related injuries throughout the period and associations with available low-low beds were analysed using Poisson regression.

Results.  During the observation of 356,158 inpatients, there were 3946 falls and 1005 fall-related injuries of which 60 (5·9%) were serious (55 fractures and five subdural haematomas). Serious fall-related injuries declined significantly throughout the period. When there was one low-low bed to nine or more standard beds there was no statistically significant decrease in serious fall-related injuries. An important reduction only occurred when there was one low-low bed to three standard beds.

Conclusion.  The 6-PACK program has been in place since 2002 at The Northern Hospital. Throughout this time serious fall-related injuries have decreased. There appears to be an association between serious fall-related injuries and the number of available low-low beds. Threshold numbers of these beds may be required to achieve optimal usability and effectiveness. A randomized controlled trial is required to give additional evidence for use of low-low beds for injury prevention in hospitals.

Ancillary