Quedas de pacientes adultos em um hospital público de ensino

Abstract

Inpatients falls suffered during their hospitalization may result in hazards. These hazards can range from minor lesions to other more serious, that can even cause death. These events are responsible for the increase of the morbidity, especially among the elderly. Considering the magnitude of the problem of falls in hospital settings, this study aimed toanalyse the adult inpatient falls recorded in the Notification of Adverse Event in a Public Teaching Hospital in Belo Horizonte. This is a quantitative, retrospective, descriptive study. The amount of 217 reports of adverse events related to falls from March 2010 to December 2012 was analysed. We performed a descriptive analysis of the general variables by section according to the literature.The incidence of falls from March 2010 to December 2012 was 7.2 falls per 1000 inpatients. Falls were more frequent in males (76.5%), in patients aged over 60 years (45.2%) and with External Causes diagnostic (34.1%). The majority of the patients were not confused (58.1%). Medications with risk for falls more commonly used by the inpatients for 24 hours before they were falling:anti-hypertensive drugs, blood/anticoagulant/antithrombotic and anti-epileptic drugs. The risk factors more frequent were observed with the use of assistive devices (93.5%), difficulty in walking (38.7%), absence of accompanying (33.6%), emotional disorder (23.0%), psychomotor agitation (24.0 %) and pain (21.6%). Falls from bed (71.0%) and in inpatient room were most common (70.0%). They were more frequent at night (63.6%). The amount of 52.5% of the falls were without injuries. Of these resulted in injuries, most were classified as minor. The average number of injuries per patient was 3.2. The assessment of nurses (65.4%) and of medical (54.8%) were the most common careprovided. The suggestions of notifications for the prevention of the event were to maintain the bed rails raise (40.6%), provide guidance to inpatient/caregiver (33.3%), maintain accompanying with patients at risk of falls (26.4%) and perform restraint (17.6%). We found out that most of the results resembled the literature. In this study, we observed that the Notification of the Adverse Event failed to characterize the patient profile, the risk factors and falls characteristics and this instrument should be revised. When analysed by clinical services, falls showed important differences in their risk factors, in the characteristics of patients and the kind of falls verified in the institution. Studies of the falls and its causes in each unit should be performed to allow that specific prevention actions may be implemented and can present results that are more effective.