Fall Risk and Nursing Problems of Patients in Medical Units
The aim of the study was to assess a fall risk and to identify nursing problems of patients in medical units.
Methods. The study was performed in two medical units at a teaching hospital from January to March of 2017. In total, 165 patients participated in the study: n=90 (response rate, 90.0%) from the Cardiology Unit and n=75 (response rate, 75.0%) from the Neurology Unit. The Morse Fall Scale was employed to assess a fall risk of patients. To assess nursing problems, a special form was developed in relation to the literature review. The study protocol was approved by the Centre of Bioethics at the Lithuanian University of Health Sciences (no. BEC-SL(B)-161).
Results. Half (50.3%) of the patiens had a high fall risk. More frequently, patients had a high fall risk in the Neurology Unit (64.0%), and a minor fall risk was relevant to half of the patients (52.2%) from the Cardiology Unit. The Cardiology Unit patients under the age ≤44 years did not have any fall risk at all although half of the Neurology Unit patients (50.0%) of this age had a minor risk and one-third (33.3%) had a high fall risk.
In both units, the patients who did not have a fall risk walked without assistance. In the Cardiology Unit, 54.3% of the patients with a high fall risk walked with a stick or a cruch. More than half of the patients in both units (57.1% in the Cardiology Unit and 56.3% in the Neurology Unit) with a high risk of falls had sleep problems. The patients with no risk of falls had no fear of falling and those with a high risk of fall felt fear of fall frequently (respectively, 37.1% in the Cardiology Unit and 39.6% in the Neurology Unit). The patients with a high risk of falls in both departments more frequently had impaired urinary elimination – nocturia (60.0% in the Cardiology Unit and 68.8% in the Neurology Unit). The patients with a high risk of falls usually had more nursing problems.
Conclusions. A high risk of falls was revealed to be a problem not only for older adults but also for younger patients, especially in the Neurology Unit. The patients with a high risk of falls usually had more nursing problems; thus, fall risk assessment and management must be integrated in nursing care planning and implementation.
Correspondence to L. Spirgienė Correspondence to L. Spirgienė, Department of Nursing, Faculty of Nursing, Lithuanian University of Health Sciences, Eivenių 4, LT‑50009 Kaunas, Lithuania. E-mail: lina.spirgiene@lsmu.lt