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Fall incidence and fall prevention practices at acute care hospitals in Singapore: a retrospective audit

Authors

  • Serena Siew Lin Koh BSc (Hons) Adv Dip (Midwifery) RN,

    Corresponding author
    1. PhD Candidate, School of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
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  • Elizabeth Manias RN CertCritCare BPharm MPharm MNStud PhD FRCNA,

    1. Associate Professor, School of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
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  • Alison M. Hutchinson RN RM BAppSc (AdvNsg) MBioeth PhD,

    1. Postdoctoral Research Fellow, School of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
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  • Linda Johnston PhD BSc Dip N RN

    1. Professor, School of Nursing, The University of Melbourne, The Royal Children’s Hospital and the Murdoch Children’s Research Institute, Melbourne, Australia
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Serena Siew Lin Koh
KK Women’s and Children’s Hospital
100 Bukit Timah Road
Singapore 229899
Singapore
E-mail: s.koh2@pgrad.unimelb.edu.au

Abstract

Objective  To investigate the incidence of falls and explore fall prevention practices at acute care hospitals in Singapore.

Design  A retrospective audit to collect baseline data on (1) incidence of falls (patient fall rates and fall injury rates) and (2) fall prevention practices, was conducted in five acute care hospitals in Singapore from December 2004 to March 2005.

Study participants  Medical record data (n = 6000) of patients admitted into the medical, surgical and geriatric units in the five hospitals.

Outcome measures  Fall incidence was obtained from the hospital’s fall databases and incident reports for the period of June 2003 to May 2004. In total, 6000 medical records from five hospitals were randomly selected, retrieved and reviewed to determine whether falls, fall assessments and interventions were being initiated and documented.

Results  The number of fallers for all hospitals was 825. Analysis showed that patient fall rates ranged from 0.68 to 1.44 per 1000 patient days, and the proportion of falls associated with injury ranged from 27.4% to 71.7%. The use of a fall risk assessment tool by nurses was recorded in 77% of all the nursing records.

Conclusion  This study has laid the foundation for further research for fall prevention in Singapore by describing current fall rates, fall-associated injury rates and the status of fall prevention practices in acute care settings. The results will be used to inform the development of a tailored multifaceted strategy to facilitate the implementation of Fall Prevention Clinical Practice Guidelines to reduce the burden of falls and fall injuries in hospitals in Singapore.

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