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. 2023 May 5;22(1):149.
doi: 10.1186/s12912-023-01322-9.

CHRONOFALLS: A multicentre nurse-led intervention in the chronoprevention of in-hospital falls in adults

Pablo Jesús López-Soto  1   2   3 , Francisco José Rodríguez-Cortés  4   5   6 , Rosa María Miñarro-Del Moral  4 , María José Medina-Valverde  4   6 , Rocío Segura-Ruiz  6 , Pedro Hidalgo-Lopezosa  4   5   6 , Roberto Manfredini  7   8 , María Aurora Rodríguez-Borrego  4   5   6 ; CHRONOFALLS project collaborators
Collaborators, Affiliations

CHRONOFALLS: A multicentre nurse-led intervention in the chronoprevention of in-hospital falls in adults

Pablo Jesús López-Soto et al. BMC Nurs. .

Abstract

Background: Falls are among the most common and serious adverse events for hospitalised patients. In-hospital falls pose a major medical and economic challenge for public health worldwide. Nevertheless, the issue is often addressed without regard to certain relevant variables such as the time of the fall. The aim of this study was to determine the effect of the implementation of a nurse-led intervention based on the temporal patterns of falls and their aetiology on the occurrence of falls.

Methods: A mixed-method research design was carried out in three phases: a) a longitudinal prospective study (audits, chronobiological analyses and implementation of a multicentre nurse-led intervention based on temporal patterns of falls); b) a retrospective study of fall records; and c) a qualitative study based on focus groups. The protocol was published in 2021.

Results: A difference was observed in the number of fall records before and after the chronopreventive intervention (retrospective: 64.4% vs. 35.6%; p < 0,001). According to the interrupted series analysis, considering the influence of the COVID-19 pandemic, a reduction in falls of 2.96% (95% CI 1.70%-4.17%) was observed. The concepts of falls, the COVID-19 pandemic and the causes of non-registration have emerged as categories for qualitative analysis.

Conclusions: A multicentric nurse-led program based on tailored organisational, educational and behavioural chronopreventive measures seems to lead to a reduction in the number of in-hospital falls. The findings of the present study, highlighting the implementation of chronopreventive measures, can serve as a basis for future health policies.

Trial registration: The project was registered on the Clinical Trials Registry NCT04367298 (29/04/2020).

Keywords: Accidental falls; Circadian rhythms; Nursing; Nursing care; Older people; Prevention; Temporal patterns.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Original and predicted number of falls between January 2018 and December 2020 in all hospitals. Nurse-led intervention was introduced in June-July 2019
Fig. 2
Fig. 2
24-h distribution of in-hospital falls pre- and post-intervention
See this image and copyright information in PMC

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