Falls as the result of interplay between nurses, patient and the environment: Using text-mining to uncover how and why falls happen.
Miyuki Takase
PMID 36860705WHAT IT FOUND
Most nurse-reported falls were unwitnessed, and reports clustered around bedrails, alarms, call bells, commodes, footwear, hypnotics, and patients walking alone.
Falls often followed care decisions, not just patient risk.
Key findings
01Most falls were unwitnessed by nurses (79.0%), and 8.7% occurred during direct nursing care.
02Most reported falls resulted in injuries (93.0%), and fractures were the most common injury (68.1%).
03The text-mining showed nurses perceived a wide range of factors and described falls as arising from interplay among patient, nursing, and environmental factors.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The clusters are based on nurses’ written descriptions, so they show how nurses understood falls, not an objective cause. Most falls were unwitnessed and many resulted in injury, which may mean minor or unwitnessed events were under-reported. The study did not compare settings with and without bedrails, alarms, call bells, or commodes, so it cannot show which measures reduce falls. Reports came from institutions participating in a Japanese incident-report database, so the clusters may not fit other health care settings.
Declared interests
This work was supported by the Japan Society for the Promotion of Science. The authors declared no conflicts of interest.
The easy way to misread this
Do not read these clusters as proof that bedrails, alarms, or call bells cause falls. They are nurses’ descriptions from incident reports, and the study did not compare fall rates with or without these measures.