4.6 Article

CHRONOFALLS: A multicentre nurse-led intervention in the chronoprevention of in-hospital falls in adults

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BMC NURSING
卷 22, 期 1, 页码 -

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BMC
DOI: 10.1186/s12912-023-01322-9

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Accidental falls; Older people; Nursing care; Nursing; Temporal patterns; Prevention; Circadian rhythms

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The study aimed to reduce in-hospital falls by implementing a nurse-led intervention based on the temporal patterns and causes of falls. Through longitudinal prospective and retrospective studies, as well as qualitative analysis, it was found that the implementation of this intervention led to a decrease in the number of falls among hospitalized patients.
BackgroundFalls are among the most common and serious adverse events for hospitalised patients. In-hospital falls pose a major medical and economic challenge for public health worldwide. Nevertheless, the issue is often addressed without regard to certain relevant variables such as the time of the fall. The aim of this study was to determine the effect of the implementation of a nurse-led intervention based on the temporal patterns of falls and their aetiology on the occurrence of falls.MethodsA mixed-method research design was carried out in three phases: a) a longitudinal prospective study (audits, chronobiological analyses and implementation of a multicentre nurse-led intervention based on temporal patterns of falls); b) a retrospective study of fall records; and c) a qualitative study based on focus groups. The protocol was published in 2021.ResultsA difference was observed in the number of fall records before and after the chronopreventive intervention (retrospective: 64.4% vs. 35.6%; p < 0,001). According to the interrupted series analysis, considering the influence of the COVID-19 pandemic, a reduction in falls of 2.96% (95% CI 1.70%-4.17%) was observed. The concepts of falls, the COVID-19 pandemic and the causes of non-registration have emerged as categories for qualitative analysis.ConclusionsA multicentric nurse-led program based on tailored organisational, educational and behavioural chronopreventive measures seems to lead to a reduction in the number of in-hospital falls. The findings of the present study, highlighting the implementation of chronopreventive measures, can serve as a basis for future health policies.

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