Citation

Singh H, Flett HM, Silver MP, Craven BC, Jaglal SB, Musselman KE. BMC Health Serv. Res. 2020; 20(1): e299.

Affiliation

Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada. Kristin.Musselman@uhn.ca.

Copyright

(Copyright © 2020, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s12913-020-05168-8

PMID

32293443

Abstract

BACKGROUND: Preventing patient falls is a priority in tertiary spinal cord injury (SCI) rehabilitation. Falls can result in patient or staff injury, delayed rehabilitation, and hospital liability. A comprehensive overview of fall prevention/management policies and procedures in Canadian SCI rehabilitation is currently lacking. We describe and compare the fall prevention/management policies and procedures implemented in Canadian tertiary hospitals that provide SCI rehabilitation.

METHODS: Fall prevention/management documents implemented in SCI rehabilitation at six Canadian tertiary rehabilitation hospitals across five provinces were analyzed using a document analysis. Analysis involved multiple readings of the documents followed by a content and thematic document analysis.

RESULTS: Fall prevention/management policies and procedures in SCI rehabilitation were organized into three main categories: 1) pre-fall policies and procedures; 2) post-fall policies and procedures; and, 3) communication between and amongst staff, patients, and families. Pre-fall policies and procedures encompassed: a) the definition of a fall; b) fall risk assessments in SCI rehabilitation; and, c) fall prevention strategies. The post-fall policies and procedures included: a) recovery from a fall; b) incident reporting process; and, c) fall classification. Components of fall prevention/management policies and practices that differed between hospitals included the fall risk assessments, post-fall huddles, and fall classifications.

CONCLUSIONS: Fall prevention/management is a required organizational practice for all hospitals. Although Canadian tertiary hospitals that provide SCI rehabilitation have similar components of fall prevention/management policies and procedures, the specific requirements differ at each site. There is a need for evidence-informed, consensus-driven implementation of SCI-specific fall prevention and management procedures across Canadian SCI rehabilitation settings.

Language: en

Keywords

Document analysis; Fall prevention; Rehabilitation; Spinal cord injuries