A main priority in hospitals in the U.S. is ensuring both patient and staff safety throughout a patient’s stay. Falls are a major concern in hospitals, particularly in critical care units (ICUs), where nurses care for increasingly older populations that are prone to falls and injuries from falls. Another issue that arises in intensive care units is the decision of when it is safe to mobilize patients, a relevant consideration in relation to incidence of falls and durations of hospital stay. Additionally, the mobilization of patients and the resulting burden on the health of critical care staff is another topic that impacts a hospital’s safety procedures and finances. The three matters together constitute areas worthy of additional research to determine effective strategies to be included in a safety framework.
The objective of the study was to review literature on patient falls, mobility, and safe patient handling to elucidate links between the three, as well as evidence-based strategies for patient and staff safety.
The authors conducted an electronic search of databases and consulted a medical librarian to find articles written from 2000 through 2009 pertaining to falls and fall prevention, mobility and mobilization, and safe patient handling in critical care environments. Research was reviewed and summarized within the three main topics. First, the authors honed in on fall risks in intensive care, looking at fall data in ICUs, the consequences of falls, fall reduction efforts, and fall risk and mobility. For the second section, they discussed safety considerations related to early mobility in critically ill patients, especially focusing on patients who are mechanically ventilated, since about 40% of ICU patients fit in this category. Finally, the authors summarized research on workplace safety for critical care staff, focusing on high-risk tasks, problems associated with certain interventions, solutions and equipment for safe patient handling, patient assessments, financial considerations, and strategies to reduce musculoskeletal disorders in critical care staff. There was limited mention of environmental variables throughout the article.
There were no findings in this summary of research relevant to the linkage between the physical environment and patient falls, patient mobilization, or work-related musculoskeletal disorders, aside from a general need for more research specific to critical care environments.