Shifting the paradigm: an assessment of the quality of fall risk reduction in Nebraska hospitals.
J Rural Health
; 31(2): 135-45, 2015.
Article
em En
| MEDLINE
| ID: mdl-25182938
ABSTRACT
PURPOSE:
To assess the prevalence of evidence-based fall risk reduction structures and processes in Nebraska hospitals; whether fall rates are associated with specific structures and processes; and whether fall risk reduction structures, processes, and outcomes vary by hospital type--Critical Access Hospital (CAH) versus non-CAH.METHODS:
A cross-sectional survey of Nebraska's 83 general community hospitals, 78% of which are CAHs. We used a negative binomial rate model to estimate fall rates while adjusting for hospital volume (patient days) and the exact Pearson chi-square test to determine associations between hospital type and the structure and process of fall risk reduction.FINDINGS:
Approximately two-thirds or more of 70 hospitals used 6 of 9 evidence-based universal fall risk reduction interventions; 50% or more used 14 of 16 evidence-based targeted interventions. After adjusting for hospital volume, hospitals in which teams integrated evidence from multiple disciplines and reflected upon data and modified polices/procedures based upon data had significantly lower total and injurious fall rates per 1,000 patient days than hospitals that did not. Non-CAHs were significantly more likely than CAHs to perform 5 organizational-level fall risk reduction processes. CAHs reported significantly greater total (5.9 vs 4.0) and injurious (1.7 vs 0.9) fall rates per 1,000 patient days than did non-CAHs.CONCLUSIONS:
Hospital type was a significant predictor of fall rates. However, shifting the paradigm for fall risk reduction from a nursing-centric approach to one in which teams implement evidence-based practices and learn from data may decrease fall risk regardless of hospital type.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Hospitais Rurais
/
Acidentes por Quedas
/
Melhoria de Qualidade
/
Segurança do Paciente
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article