Register      Login
Brain Impairment Brain Impairment Society
Journal of the Australasian Society for the Study of Brain Impairment
RESEARCH ARTICLE

Falls on an inpatient brain injury rehabilitation unit … What are the consequences?

Kathryn Marshall https://orcid.org/0000-0001-6971-1773 A * , Janelle Griffin A , Joshua Knowles B , Shannon Galletly C , Freyr Patterson D and Ryan Bell C
+ Author Affiliations
- Author Affiliations

A Princess Alexandra Hospital, Occupational Therapy, Brisbane, Qld, Australia.

B QCIF, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Qld, Australia.

C Princess Alexandra Hospital, Brain Injury Rehabilitation Service, Brisbane, Qld, Australia.

D University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Qld, Australia.


Handling Editor: Suzanne Kuys

Brain Impairment 25, IB24021 https://doi.org/10.1071/IB24021
Submitted: 14 March 2024  Accepted: 9 November 2024  Published: 3 December 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of the Australasian Society for the Study of Brain Impairment.

Abstract

Background and objectives

Falls research has explored the characteristics of patients with a brain injury who experienced falls and the nature of these falls. However, the characteristics of falls with consequence have not yet been investigated. This study aimed to explore the consequences of patient falls in inpatient brain injury rehabilitation.

Method

Data were retrospectively analysed from incident reports and patient medical charts. Participants were included who had fallen during brain injury rehabilitation at a metropolitan hospital between January 2017 and December 2021. Falls with a reported consequence including pain, laceration, soft tissue injury, fracture and traumatic brain injury (consequential falls) were compared to falls that did not have a consequence. Significant patient and fall variables for a fall with consequence were explored.

Results

Over the 5-year study period 855 patients were admitted and 161 patients (64% male) experienced 276 falls. Of the 161 patients, 90 (56%) experienced a consequence from one or more falls, with 119 (43%) of falls having consequences. The odds of a consequential fall increased 1.03 times for each year increase in age. The odds of a consequential fall in autumn, winter, and spring were two to three times higher than in summer and were 3.6 times higher when the fall was unwitnessed by staff.

Conclusions

More falls with consequence occurred with increasing age and when unwitnessed by staff. This knowledge supports the need for older persons to have additional supervision and assistance during inpatient brain injury rehabilitation to reduce harm from falls.

Keywords: brain injury, consequence, fall, faller, rehabilitation.

References

Aihara S, Kitamura S, Dogan M, Sakata S, Kondo K, Otaka Y (2021) Patients’ thoughts on their falls in a rehabilitation hospital: a qualitative study of patients with stroke. BMC Geriatrics 21(1), 713.
| Crossref | Google Scholar | PubMed |

Australian Commission on Safety and Quality in Health Care (2021) ‘Incident Management Guide.’ (ACSQHC: Sydney, NSW, Australia)

Australian Institute of Health and Welfare (2023) ‘Injury in Australia: Falls.’ (AIHW: Canberra, ACT, Australia)

Ehrlich C, Lewis D, New A, Jones S, Grealish L (2022) Exploring the role of nurses in inpatient rehabilitation care teams: A scoping review. International Journal of Nursing Studies 128, 104134.
| Crossref | Google Scholar | PubMed |

Ghosh M, O’Connell B, Afrifa-Yamoah E, Kitchen S, Coventry L (2022) A retrospective cohort study of factors associated with severity of falls in hospital patients. Scientific Reports 12(1), e12266.
| Crossref | Google Scholar | PubMed |

Gregory KE, Radovinsky L (2012) Research strategies that result in optimal data collection from the patient medical record. Applied Nursing Research 25(2), 108-116.
| Crossref | Google Scholar | PubMed |

Guo M, Mandurah R, Tam A, Bayley M, Kam A (2022) The incidence and nature of adverse events in rehabilitation inpatients with acquired brain injuries. Physical Medicine and Rehabilitation 14(7), 764-768.
| Crossref | Google Scholar | PubMed |

Healey F, Scobie S, Oliver D, Pryce A, Thomson R, Glampson B (2008) Falls in English and Welsh hospitals: a national observational study based on retrospective analysis of 12 months of patient safety incident reports. Quality & Safety in Health Care 17(6), 424-430.
| Crossref | Google Scholar | PubMed |

Hignett S, Sands G, Griffiths P (2013) In-patient falls: what can we learn from incident reports? Age And Ageing 42(4), 527-531.
| Crossref | Google Scholar | PubMed |

Lamb SE, Jørstad-Stein EC, Hauer K, Becker C (2005) Development of a common outcome data set for fall injury Prevention trials: The Prevention of Falls Network Europe Consensus. Journal of The American Geriatrics Society 53(9), 1618-1622.
| Crossref | Google Scholar | PubMed |

Lewis J, Heinemann T, Jacques A, Chan K, Harper KJ, Nolan J (2024) Lateropulsion is a predictor of falls during inpatient stroke rehabilitation. Annals of Physical and Rehabilitation Medicine 67(2), e101814.
| Crossref | Google Scholar | PubMed |

McKechnie D, Fisher MJ, Pryor J (2016a) The characteristics of falls in an inpatient traumatic brain injury rehabilitation setting. Journal of Clinical Nursing 25(1–2), 213-222.
| Crossref | Google Scholar | PubMed |

McKechnie D, Fisher MJ, Pryor J (2016b) A Case-control Study Examining the Characteristics of Patients who Fall in an Inpatient Traumatic Brain Injury Rehabilitation Setting. The Journal of Head Trauma Rehabilitation 31(2), 59-70.
| Crossref | Google Scholar | PubMed |

Parker TD, Rees R, Rajagopal S, Griffin C, Goodliffe L, Dilley M, Jenkins PO (2022) Post traumatic amnesia. Practical Neurology 22, 129-137.
| Crossref | Google Scholar | PubMed |

Persson CU, Hansson P (2021) Determinants of falls after stroke based on data on 5065 patients from the Swedish Väststroke and Riksstroke Registers. Scientific Reports 11(1), e25035.
| Crossref | Google Scholar | PubMed |

Quigley P (2016) Evidence levels: applied to select fall and fall injury prevention practices. Rehabilitation Nursing Journal 41(1), 5-15.
| Crossref | Google Scholar | PubMed |

Rabadi MH, Rabadi FM, Peterson M (2008) An Analysis of Falls Occurring in Patients with Stroke on an Acute Rehabilitation Unit. Rehabilitation nursing 33(3), 104-109.
| Crossref | Google Scholar | PubMed |

Staggs VS, Mion LC, Shorr RI (2014) Assisted and unassisted falls: different events, different outcomes, different implications for quality of hospital care. The Joint Commission Journal on Quality and Patient Safety 40(8), 358-364.
| Crossref | Google Scholar | PubMed |

State of Queensland (2023) ‘Best practice guide to clinical incident management.’ (Queensland Health: Qld, Australia)

Tsur A, Yakir O (2019) Inpatient falls in a hospital rehabilitation department. JSM Physical Medicine and Rehabilitation 3(1), 1012-1016.
| Crossref | Google Scholar |

Ullah S, Al-Atwi MK, Qureshi AZ, Tantawy SS, Wunderlich CA (2019) Falls in individuals with stroke during inpatient rehabilitation at a tertiary care hospital in Saudi Arabia. Neurosciences (Riyadh, Saudi Arabia) 24(2), 130-136.
| Crossref | Google Scholar | PubMed |

Wilson A, Kurban D, Noonan VK, Krassioukov A (2020) Falls during inpatient rehabilitation in spinal cord injury, acquired brain injury, and neurologmusculoskeletal disease programs. Spinal Cord 58(3), 334-340.
| Crossref | Google Scholar | PubMed |

Wong JS, Brooks D, Mansfield A (2016) Do falls experienced during in-patient stroke rehabilitation affect length of stay, functional status, and discharge destination? Archives of Physical Medicine and Rehabilitation 97(4), 561-566.
| Crossref | Google Scholar | PubMed |