Keywords
fall prevention
clinical risk management
Abstract
Introduction: Umberto I Teaching Hospital adopted 'Scale of Conley' as internal procedure for fall risk assessment, with the aim of strengthening surveillance and improving prevention and management of impatient falls.
Materials and Methods: Case-control study was performed. Fall events from 1st March 2012 to 30th September 2013 were considered. Cases have been matched for gender, department and period of hospitalization with two or three controls when it is possible. A table including intrinsic and extrinsic fall risk factors, not foreseen by Conley Scale, and setted up after a literature overview was built. Univariate analysis and conditional logistic regression model have been performed.
Results: 50 cases and 102 controls were included. Adverse event fall were associated with filled Conley scale at the admission to care unit (OR=4.92, 95%CI= 2.34-10.37). Univariate analysis identified intrinsic factors increasing risk of falls: dizziness (OR= 3.22; 95%CI= 1.34-7.75), psychomotor agitation (OR= 2.61; 95%CI= 1.06-6.43); and use of means of restraint (OR=5.05 CI= 1.77-14.43). Conditional logistic regression model revealed a significant association with the following variables: use of instruments of restraint (HR= 5.54, 95%IC= 1.2-23.80), dizziness (OR= 3.97, 95%CI= 1.22-12.89).
Discussion: Conley Scale must be filled at the access of patient to care unit. There were no significant differences between cases and controls with regard to risk factors provided by Conley, except for the use of means of restraint. Empowerment strategies for Conley compilation are needed.
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