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Geriatrics 2018, 3(1), 9; https://doi.org/10.3390/geriatrics3010009

One-Year Mortality Rates Before and After Implementing Quality-Improvement Initiatives to Prevent Inpatient Falls (2012–2016)

1
Department of Geriatric Medicine, Ysbyty Ystrad Fawr, Aneurin Bevan University Health Board, Ystrad Mynach, Wales CF82 7EP, UK
2
Royal Gwent Hospital, Newport, Aneurin Bevan University Health Board, Wales NP20 2UB, UK
3
Acute Medicine, Ysbyty Ystrad Fawr, Aneurin Bevan University Health Board, Ystrad Mynach, Wales CF82 7EP, UK
*
Author to whom correspondence should be addressed.
Received: 24 January 2018 / Revised: 20 February 2018 / Accepted: 3 March 2018 / Published: 5 March 2018
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Abstract

Single-room ward design has previously been associated with increased risk of inpatient falls and adverse outcomes. However, following quality initiatives, the incidence of inpatient falls has shown a sustained reduction. Benefits have also been observed in the reduction of hip fractures. However, one-year mortality trends have not been reported. The aim of this observational study is to report the trends in one-year mortality rates before and after implementing quality-improvement initiatives to prevent inpatient falls over the last 5 years (2012–2016). This retrospective observational study was conducted for all patients who had sustained an inpatient fall between January 2012 and December 2016. All the incident reports in DATIX patient-safety software which were completed for each inpatient fall were studied, and the clinical information was extracted from Clinical Work Station software. Mortality data were collected on all patients for a minimum of one year following the discharge from the hospital. The results show that 95% patients were admitted from their own homes; 1704 patients had experienced 3408 incidents of an inpatient fall over 5 years. The mean age of females (82.61 ± 10.34 years) was significantly higher than males (79.36 ± 10.14 years). Mean falls/patient = 2.0 ± 2.16, range 1–33). Mean hospital stay was 45.43 ± 41.42 days. Mean hospital stay to the first fall was 14.5 ± 20.79 days, and mean days to first fall prior to discharge was 30.8 ± 34.33 days. The results showed a significant and sustained reduction in the incidence of inpatient falls. There was a downward trend in the incidence of hip fractures over the last two years. There was no significant difference in the inpatient and 30-day mortality rate over the last five years. However, mortality trends appear to show a significant downward trend in both six-month and one-year mortality rates over the last two years following the implementation of quality initiatives to prevent inpatient falls. A significant reduction in the incidence of inpatient falls following quality initiatives initially has been observed, followed by a downward trend in the incidence of hip fractures. We have just started to observe a significant reduction in the 6-month and one-year mortality. We propose prompt completion of multifactorial falls risk assessments, and every possible quality initiative should be taken to prevent a ‘first inpatient fall’, which should result in the sustained improvement of clinical outcomes. View Full-Text
Keywords: inpatient falls; death; hip fracture; hospital stay; single rooms inpatient falls; death; hip fracture; hospital stay; single rooms
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Singh, I.; Edwards, C.; Anwar, A. One-Year Mortality Rates Before and After Implementing Quality-Improvement Initiatives to Prevent Inpatient Falls (2012–2016). Geriatrics 2018, 3, 9.

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