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5PSQ-118 Surveillance and monitoring of patient falls in a hospital setting by the hospital pharmacist: focus on patient-related risk factors and drug therapy
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  1. E Di Martino,
  2. D Leonardi Vinci,
  3. P Polidori
  1. Ismett, Clinical Pharmacy, Palermo, Italy

Abstract

Background Falls in hospitalised patients (FHPs) represent the most common adverse event in a hospital setting that can increase hospitalisation stay.

Purpose The aim of this study was to identify the risk factors related to FHPs.

Material and methods We analysed 65 falls of 61 patients that occurred in our institute from January 2013 to May 2018. There were identified patient-related risk factors (age, gender, body mass index, diseases, postoperative status, need of assistance and previous fall in the past 6 months) and therapy-related risk factors, such as the presence of fall-risk-increasing drugs (FRIDs) reported in the literature.

Results 19.7% (12/61) of the fallen patients were aged under 60 years, 45.9% (28/61) between 60 and 70 years, 31.1% (19/61) between 70 and 80 years, while 3.3% (2/61) were over 80 years. 68.9% (42/61) of the patients were males, while 31.1% (19/61) were females. 96.7% (59/61) had predisposing factors to FHPs. 55.7% (34/61) were overweight and 1.6% (1/61) were underweight. 44.3% (27/61) required total care, while 27.9% (17/61) required partial assistance. In 40% (26/65) of the FHPs, the patients were in a postoperative care, while in 31.1% (19/65) of FHPs, the patients had fallen in the previous 6 months. In 35.4% (23/65) of the FHPs, one or more diagnostic tests were necessary, for a total amount of 33 examinations. In 96.9% (63/65) of the reported falls, the patients were in polytherapy and assumed FRIDs, with an average of 7.3 FRIDs per patient: the most representative classes of FRIDs were cardiovascular drugs in 47.4% (227/479), hypoglycaemics in 12.1% (58/479), proton pump inhibitors in 11.3% (54/479), laxatives in 7.1% (34/479), opioids in 6.9% (33/47) and anxiolytics in 5% (24/479). The most frequent FRIDs were furosemide in 14.2% (68/479), omeprazole in 9.8 (47/479), insulin lispro in 5.4% (26/479) and tramadol in 5.2% (25/479).

Conclusion This analysis shows some critical points that required the implementation of preventive and safety measures, in order to reduce the incidence of FHIPs. We propose to perform: frequent fall-risk assessments of each patient through appropriate assessment scales; greater attention to drug therapy; and adequate training of healthcare professionals.

References and/or acknowledgements No conflict of interest.

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