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Post-fall reporting in aged acute inpatient mental health units: an 18-month observational cohort study

Published online by Cambridge University Press:  04 September 2017

Trentham Furness Open the ORCID record for Trentham Furness [Opens in a new window] ,
George Mnatzaganian ,
Robyn Garlick ,
Susan Ireland ,
Brian McKenna  and
Keith D. Hill
Trentham Furness*
Affiliation:
School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia NorthWestern Mental Health, The Royal Melbourne Hospital, Parkville, Victoria, Australia
George Mnatzaganian
Affiliation:
College of Science, Health and Engineering, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
Robyn Garlick
Affiliation:
NorthWestern Mental Health, The Royal Melbourne Hospital, Parkville, Victoria, Australia
Susan Ireland
Affiliation:
NorthWestern Mental Health, The Royal Melbourne Hospital, Parkville, Victoria, Australia
Brian McKenna
Affiliation:
School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand Auckland Regional Forensic Psychiatry Services, Waitemata District Health Board, Auckland, New Zealand
Keith D. Hill
Affiliation:
School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
*
Correspondence should be addressed to: Trentham Furness, NorthWestern Mental Health, The Royal Melbourne Hospital, Grattan Street, Parkville, Victoria 3050, Australia. Phone: +61 3 9342-8255. Email: trentham.furness@acu.edu.au.
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Abstract

Background:

Despite the high risk of falling for people with severe mental illness, there is limited falls research in mental health settings. Therefore, the objective of this observational cohort study was to conduct a focused post-fall review of fall episodes within aged acute inpatient mental health units at one of Australia's largest publicly funded mental health organizations.

Methods:

A post-fall reporting tool was developed to collect intrinsic and extrinsic fall risk factors among three aged acute mental health inpatient units over an 18-month period. Descriptive and inferential analyses were conducted to describe fall risk factors and predictors of fall risk.

Results:

There were a total of 115 falls, of which the tool was used for 93 (80.9%) episodes. Falls occurred most often in consumer's bedroom/bathroom and were unwitnessed. Intrinsic risk factors were most often attributed to postural drop and losing balance during walking. However, that was in contrast to consumer's who self-reported feeling dizzy as the reason of the fall.

Conclusions:

Based on the cohort, future falls could be reduced by targeting those aged above 82 years, or with a diagnosis of dementia. Recurrent falls during admission could be reduced by targeting those with psychotic illness and males with a diagnosis of dementia. A clearer dialogue among consumers and clinical staff reporting about fall episodes may support future remedial interventions and inform programs to reduce fall risk and assist the challenge of describing unwitnessed falls in aged acute inpatient mental health settings.

Keywords

fallsagingclinical assessmentdementiaprimary carepsychosisrisk factorsschizophrenia
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 12 , December 2017 , pp. 2007 - 2016
Copyright
Copyright © International Psychogeriatric Association 2017 

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