Patient falls reduction in a hospital: influence of environmental and organizational changes

Patient falls in hospitals have mostly multifactorial causes. Research is mainly centred in the identification of patient (intrinsic) risk factors. Other risk factors from the physical and organizational environment are frequently unrecognized, that doesn't allow identifying the potential risk that they can have on falls. This research aims to understand the influence of environmental and organizational hospital changes in the reduction of patient's falls. In order to achieve this objective, we analysed information from a hospital falls database from 2012 to 2014. There has been a total 361 falls recorded during 2012-2014. Falls occur mainly in General Internment (37%), followed by Department of Surgery (15%) and Emergency Room (13%). During this period (2012-2014) nevertheless the increasing of patient safety hospital reports there was a falls reduction of 55%. Patient health conditions contributed to the reduction in 46%, (OR=0.505; CI 95%= 0.254-1.005, p=0.052). Patient falls related with environmental and organizational risk factors have a reduction of 67% (OR=1.968; CI 95%= 1.077-3.597, p=0.028). Facilities changes and equipment renewal contributed positively to falls reduction during this period. Patient's falls may be also be reduced if at organizational level there are specific preventive measures for patients with a high risk of falling.