A review of environmental hazards associated with in-patient falls

Authors: Hignett, S.¹; Masud, T.²

Source: Ergonomics, Volume 49, Numbers 5-6, -6/15 April–15 May 2006 , pp. 605-616(12)

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Abstract:

Slips, trips and falls present the greatest risk to in-patients in terms of exposure (frequency of occurrence) but only present a low severity risk in terms of mortality. The risk factors have been categorized as intrinsic (individual to the patient, e.g. visual impairment, balance problems and medicine use) or extrinsic (environmental). Many recommendations have been made concerning the management of environmental hazards but, of these, only beds rails have supporting research evidence. Other recommendations include patient assessment, footwear, flooring, lighting, staffing levels and bed alarms. However, three systematic reviews and the current narrative review have all failed to find research evaluating the benefits of these recommendations. The most robust evidence relates to the use of bed rails. This research suggests that bed rails not only fail to reduce the frequency of falls, but may also exacerbate the severity of injury. As Maslow's Hierarchy of Needs model has been used as a framework for nursing models of care, it was chosen as the basis for the development of an environmental hazard assessment model. The environmental hazards are revisited using this model in order to take an ergonomic or patient-centred approach for risk assessment.

Keywords: Health-care ergonomics; Patient safety; Falls; User-centred design

Document Type: Research article

DOI: http://dx.doi.org/10.1080/00140130600568949

Affiliations: 1: Healthcare Ergonomics and Patient Safety Research Unit, Dept. of Human Sciences, Loughborough University, Loughborough, LE11 3TU, Leics, UK 2: Clinical Gerontology Research Unit, Nottingham City Hospital NHS Trust, Hucknall Road, Nottingham, NG5 1PB, UK

Publication date: 2006-01-01

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A review of environmental hazards associated with in-patient falls

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