Current state of fall prevention and management policies and procedures in Canadian spinal cord injury rehabilitation

• Published in: BMC health services research Vol. 20; no. 1; p. 299
• Main Authors: Singh, Hardeep, Flett, Heather M, Silver, Michelle P, Craven, B Catharine, Jaglal, Susan B, Musselman, Kristin E
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 15-04-2020; BioMed Central; BMC
• Subjects: Accident prevention; Accidental falls; Analysis; Canada; Communication; Document analysis; Fall prevention; Falls; Health services; Hospitals; Injury prevention; Legal liability; Patient safety; Prevention; Rehabilitation; Risk assessment; Spinal cord injuries; Canada; Spinal cord injuries; Fall prevention; Rehabilitation; Document analysis
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-020-05168-8

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.
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.
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.
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.