A significantly higher number of patient falls occur in hospital inpatient psychiatric units than in medical-surgical areas, resulting in issues with overall patient safety. The Centers for Disease Control and Prevention considers patient falls a concern to society due to the safety issues they pose and financial strains they can cause for institutions.
This study explores different psychiatric unit directors’ perceptions regarding the variables that contribute to patient falls.
Program directors, nurse managers, supervisors, and administrators with various managerial roles from 60 different psychiatric units were interviewed. Twenty-two questions were posed to all participants asking what they believed were the intrinsic and extrinsic factors that contributed to patient falls within inpatient psychiatric units, as well as questions regarding staff training and safety equipment.
Survey responses indicated that participants generally agreed that the intrinsic factors contributing the most to patient falls were having fallen in the past, taking multiple psychotropic medications, and having an unsteady gait. Participants indicated that extrinsic factors that helped decrease the number of patient falls were physical therapy evaluations, scheduled toileting, adequate staffing levels, and multidisciplinary team support. Overall, participants believed that intrinsic factors were more strongly related to the likelihood of patient falls than extrinsic factors. For staff training, participants agreed that current staff should undergo recurrent training and education regarding patient falls, and for safety equipment, participants agreed that issues with adequate footwear posed more risk than the absence of wall-mounted grab bars.
Participants were limited to 22 questions that focused on specific research themes of predetermined intrinsic and extrinsic factors. Each survey question was limited to five possible responses, eliminating the possibility of elaboration by the participants.