Verification of the causes of and countermeasures for falls using fall assessment score sheets in a municipal hospital

Abstract

Aim. This study aimed to examine the causes and countermeasures concerning falls through evaluating patient falls assessment score sheets at admission and retrospectively examining medication use and biochemical evaluation results. Methods. The medical records of patients hospitalized for 11 months from April 2018 to March 2019 were reviewed anonymously on the basis of medical safety and the safety of medical supplies, and the number of falls was determined. Moreover, the cause and number of falls were reviewed retrospectively based on patient falls assessment score sheets. On assessment of the causes of falls during hospitalization, activity restrictions were noted and physical restraints had been implemented to assist with activities of daily living due to suspected frailty syndrome. Results. As a result of the evaluation of the fall assessment score sheet, 256 patients (90.5%) were aged 65 years or older, and most of the hospitalized patients were elderly. Regarding the history of falls, the number of males aged 65 years or older (136 patients) with a history of falls was approximately 2.7 times that of those without a history (99 patients), and the number of female patients (120 patients) with a history of falls was twice that of those without a history of falls (80 patients). As fall assessment items, it was confirmed that needing assistance for elimination, patient use of accessories, IVs, gastric tubes, drains, and use of wheelchair toilets contributed to the cause of falls. Biochemical evaluations indicated that patients categorized as underweight, based on their body mass index, had lower total protein, albumin, and hemoglobin levels than obese patients. Conclusions. To reduce the occurrence of falls, a patient’s nutritional status and muscle mass should be considered using a falls assessment score sheet at admission. Furthermore, falls may be prevented through evaluating a patient’s nutritional status from a biochemical perspective.