Study of Factors that Lead to Falls During Body Position Change from a Dorsal Position to a Seated Position by Nursing Students

Abstract

In Japan, medical accidents were defined as “accidents stemming from medical care provided by healthcare provider” in the 2014 revision to the Medical Service Law. 38.4% of medical accidents involve incidents that happen during recuperative care, such as falling or falling from the bed. These accidents occurred most frequently among various types of medical accidents. According to a report by the Japan Council for Quality Health Care (JCQHC), 1,590 falling incidents were recorded among 643 medical facilities in one year. Out of those, 7 incidents led to death. And 84 incidents out of the 1,590 falling incidents were caused by falling accident from the bed, and 6 incidents led to death. According to the analysis of JCQHC, most of these falling accidents were caused by actions initiated by the patient, and to this day, there is no clarity on the subject of falling accidents caused by healthcare providers. Furthermore, in terms of falls associated with position changing of the patient in bed, previous research based on action analysis was nowhere to be found, either in or outside of the country. In this research, we conducted a 3-dimensional action analysis using a MAC 3D SYSTEM on 13 non-expert nursing students and 2 expert nurses with 27 years of experience, as they performed a position change on patients from a dorsal to a seated position. Sudden falls from the bed were reported for simulated patients (SP) of 3, or 23.1%, of the nursing students. Our study attempts to address the factors that contribute to falling in the simulated patients when being transitioned from a dorsal to a seated position, and giving shape to the tacit skills employed in nursing care. The significance of this research is that it contributes to better medical safety, and to developing measures that help prevent falling incidents during position changing by caregivers. Results from this study revealed that non-expert nursing students moved faster and positioned themselves at a greater distance compared with the experts from their simulated patients when positioning them from a dorsal to a sitting position, and that these were contributing factors to the falling incidents of patients.