Factors associated with falls among in-patients in medical and surgical wards at Kenyatta national hospital, Kenya.

Abstract

Falls are tile third most common cause of unintentional injury and death across all age groups and the leading cause among people 65 years and older (Tzeng and Yin, 2008). The aim of this study was to assess the prevalence of falls and the factors associated with them among inpatients in medical and surgical wards of Kenyaua National Hospital. This hospital is the main national referral and teaching health facility in Kenya with a bed capacity of 1800. Data was collected from patients using questionnaire, key informant interviews involving senior nurses and environmental observation. Descripti ve statistics (mean, median, mode and standard deviation) and inferential statistics (Chi-Square and t-test) were used to explain relationships between variables. Study findings indicated that a total of 22(13%) in-patient falls were reported in above wards of which 7 resulted to injury. The mean age of fallers was 51years; range was 24-84 years with a high prevalence among patients aged above 55 years. The significant risk factors that correlated to patient falls were age, P< 0.01 (Cl, 43-57, t=14.6), impaired mobility (weakness) which led to falls while patients were alone at P= 0.002 and the length of stay, P=0.03. The significant personal risk factors identified as potential fall risks included dizziness and inability to get in or out of chair or bed without support P=0.017, Sensory deficit (visual), P=O.OOI and elimination related problems (high frequency of urination), P=O.002. Fall prevention strategies included patient restraint, close monitoring of patients at risk and physiotherapy. Challenges faced in patient fall prevention interventions were inadequate nursing staff, inadequate and inappropriate equipment and diversion of duties by nurses. Falls are common among in-patients. The study recommends that the hospital prioritizes falls as one of the significant incidences/accidents that befall inpatients, design protocols for reporting and strengthen strategies for prevention of in-patient falls.