Abstract
Aims
Falls are a common occurrence among hospital inpatients and can lead to injury, prolonged hospitalisation and delayed rehabilitation. There is major economic burden associated with this. Post operative orthopaedic patients have certain risk factors that predispose them to falls including decreased mobility, use of opioids and, in some cases, history of previous falls.
Methods
A Prospective cohort study with a historical control group was performed looking at falls before and after implementation of a Falls Prevention Program (FFP). A cost analysis of the intervention was then undertaken. Patient data, HIPE data and fall-incident report data were reviewed to identify fall-related injuries and related costs.
Results
A total of 415 falls occurred over a 5 year period pre-intervention. The fall rate of 3.49/1000 bed days pre-intervention was significantly higher than the fall rate post-intervention (2.68/1000 bed days) (p=0.0348). There was a significant decrease in falls relating to elimination (p=0.0025). Elective patients also fell less in the post-intervention period (p=0.0115). 85 falls occurred in the 12 months pre-intervention. 15.29% (13/85) of falls resulted in minor injuries, and 9.42% (8/85) resulted in major injuries. The total cost incurred during this period as a result of falls was €84,285.74. Over 95% of total costs related to patients who sustained a hip fracture (n=4). The total cost of implementing the FFP was €11,234.25. In the 12 months post-intervention, 52 falls occurred. 25% (13/52) of falls resulted in minor injuries, and 5.76% (2/52) resulted in major injuries (no hip fractures). The total costs accrued during this period as a result of falls was €510.60.
Conclusion
Following the implementation of a FPP the incidence of falls and consequent costs decreased significantly. The large proportion of saving results from preventing hip fractures.
