TY - JOUR
T1 - Physical Design Factors Contributing to Patient Falls
AU - Pati, Debajyoti
AU - Valipoor, Shabboo
AU - Cloutier, Aimee
AU - Yang, James
AU - Freier, Patricia
AU - Harvey, Thomas E.
AU - Lee, Jaehoon
N1 - Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
PY - 2021/4/1
Y1 - 2021/4/1
N2 - Objectives The aim of this study was to identify physical design elements that contribute to potential falls in patient rooms. Methods An exploratory, physical simulation-based approach was adopted for the study. Twenty-seven subjects, older than 70 years (11 male and 16 female subjects), conducted scripted tasks in a mockup of a patient bathroom and clinician zone. Activities were captured using motion-capture technology and video recording. After biomechanical data processing, video clips associated with potential fall moments were extracted and then examined and coded by a group of registered nurses and health care designers. Exploratory analyses of the coded data were conducted followed by a series of multivariate analyses using regression models. Results In multivariate models with all personal, environmental, and postural variables, only the postural variables demonstrated statistical significance - turning, grabbing, pushing, and pulling in the bathroom and pushing and pulling in the clinician zone. The physical elements/attributes associated with the offending postures include bathroom configuration, intravenous pole, door, toilet seat height, flush, grab bars, over-bed table, and patient chair. Conclusions Postural changes, during interactions with the physical environment, constitute the source of most fall events. Physical design must include simultaneous examination of postural changes in day-to-day activities in patient rooms and bathrooms. Among discussed testable recommendations in the article, the followings design strategies should be considered: (a) designing bathrooms to reduce turning as much as possible and (b) designing to avoid motions that involve 2 or more of the offending postures, such as turning and grabbing or grabbing and pulling, and so on.
AB - Objectives The aim of this study was to identify physical design elements that contribute to potential falls in patient rooms. Methods An exploratory, physical simulation-based approach was adopted for the study. Twenty-seven subjects, older than 70 years (11 male and 16 female subjects), conducted scripted tasks in a mockup of a patient bathroom and clinician zone. Activities were captured using motion-capture technology and video recording. After biomechanical data processing, video clips associated with potential fall moments were extracted and then examined and coded by a group of registered nurses and health care designers. Exploratory analyses of the coded data were conducted followed by a series of multivariate analyses using regression models. Results In multivariate models with all personal, environmental, and postural variables, only the postural variables demonstrated statistical significance - turning, grabbing, pushing, and pulling in the bathroom and pushing and pulling in the clinician zone. The physical elements/attributes associated with the offending postures include bathroom configuration, intravenous pole, door, toilet seat height, flush, grab bars, over-bed table, and patient chair. Conclusions Postural changes, during interactions with the physical environment, constitute the source of most fall events. Physical design must include simultaneous examination of postural changes in day-to-day activities in patient rooms and bathrooms. Among discussed testable recommendations in the article, the followings design strategies should be considered: (a) designing bathrooms to reduce turning as much as possible and (b) designing to avoid motions that involve 2 or more of the offending postures, such as turning and grabbing or grabbing and pulling, and so on.
KW - bathroom
KW - clinician zone
KW - motion capture
KW - patient fall
KW - patient room
KW - physical design
UR - http://www.scopus.com/inward/record.url?scp=85011632829&partnerID=8YFLogxK
U2 - 10.1097/PTS.0000000000000339
DO - 10.1097/PTS.0000000000000339
M3 - Article
C2 - 28157790
AN - SCOPUS:85011632829
SN - 1549-8417
VL - 17
SP - E135-E142
JO - Journal of Patient Safety
JF - Journal of Patient Safety
IS - 3
ER -