Effectiveness of nursing care provided for fall prevention: Survival analysis of nursing records in a tertiary hospital.

Abstract

This study was carried out to analyze nursing care provided to patients on high and low fall-risk days and to evaluate the effectiveness of nursing care in terms of preventing falls. A retrospective review of medical records was conducted for patients admitted to a tertiary hospital in Korea. General and clinical information, fall occurrences, Hendrich II Fall Risk Model (HFRM II) fall-risk assessment scores, nursing care related to fall prevention, and medications administered were extracted. Data from 43,267 days of records for 11,718 patients were analyzed. Nursing assessment, intervention, and administration of medication were provided more frequently on high fall-risk days than on low fall-risk days. Analysis performed on the entire cohort days showed fall occurrence was significantly associated with infrequent mobility assessment and greater usage of anti-anxiety agents. On high fall-risk days, fall occurrence was related to less restraint assessment and greater usage of vessel dilatators. The implementation of risk-targeted interventions for fall prevention based on fall-risk assessment is needed. For general fall prevention, assessment of patients' mobility should be strengthened. For high fall-risk patients, it may be more effective for nurses to focus on assessing restraints, evaluating medication records, and withdrawing medications related to falls.