Do portable nursing stations within bays of hospital wards reduce the rate of inpatient falls? – An Interrupted Time Series Analysis
Ali U., Judge None., Brooke A., Foster C., Marriot T., Lamb SARAH.
Background: Falls can negatively affect patients, resulting in loss of independence and functional decline, and have substantial healthcare costs. Hospitals are a high-risk falls environment and regularly introduce, but seldom evaluate, policies to reduce inpatient falls. This study evaluated whether introducing portable nursing stations in ward bays to maximise nurse-patient contact time reduced inpatient falls. Methods: Inpatient falls data from local hospital incident reporting software (Datix) were collected monthly (April 2014-December 2017) from 17 wards in Stoke Mandeville and Wycombe General Hospitals, UK. Portable nursing stations were introduced in bays on these wards from April 2016. We used a natural experimental study design and interrupted time series analysis to evaluate changes in fall rates, measured by the monthly rate of falls per 1000 occupied bed days (OBDs). Results: The wards reported 2875 falls (April 2014 – December 2017). The fallers’ mean age was 78 (SD=13) and 58% (1624/2817) were men. Most falls, 99.41% (2858/2875), resulted in none, low, or moderate harm, 0.45% (13/2875) in severe harm, and 0.14% (4/2875) in death. The monthly falls rate increased by 0.119 per 1000 OBDs (95% CI: 0.045, 0.194; p=0.002) before April 2016, then decreased by 0.222 per 1000 OBDs (95% CI: -0.350, -0.093; p=0.001) until December 2017. At 12 months post-intervention, the absolute difference between the estimated post-intervention trend and pre-intervention projected estimate was 2.84 falls per 1000 OBDs, a relative reduction of 26.71%. Conclusion: Portable nursing stations were associated with lower monthly falls rates and could reduce inpatient falls across the NHS.