Avaliação do risco de quedas em pacientes adultos hospitalizados

Abstract

The fall of hospitalized patients is a world reality and the most frequent adverse events in this environment. This study aims to evaluate the risk of falls among adult patients in clinical and surgical unit of a university hospital. It is a cohort study with follow up of patients admitted in the Surgical Clinic and Medical I and II Clinic of the Hospital Universitário de Santa Maria (HUSM) between March to June 2013 (122 days). For data collection was utilized semi-structured form with demographic and clinical questions of patients and the Brazilian version of the Morse Fall Scale (SPS) was used. The data were organized in Excel ® with double entered independently. After the correction of errors and inconsistencies the analysis was realized in PASW ® Statistics (Predictive Analytics Software, Chicago - USA) version 18.0 for Windows, using the descriptive and inferential statistics. The study included 831 patients. Of these patients 60.2 % were male, the mean age was 58.1 (± 16.1) years , were on average 7.7 days (± 9.2) and were hospitalized on average 5.4 days (± 5.2) for evaluation. During the period 19 patients fell the floor / ground representing an average of 4.7 falls / month, a percentage of 2.28 % (95% CI: 1.66 to 2.91) falls in the period and a fee incidence of 1.68 % (95% CI: 1.51 to 1.72 % ). The MFS score had averaged 39.37 points (± 19.4). In the first evaluation and in the average final evaluation higher percentage of patients were classified as high risk for falls (36.6 %, 37.7 % and 41.2 %, respectively), with strong positive correlation between the first and final evaluation (r = 0.810, p = 0.000). The falls occurred between the 1st and 10th day of evaluation (85.7 %) during the morning (52.4 %), in the ward (at the bedside), bathroom and during the displacement, resulting in psychological harm (58.8 %) and physical (29.4%). Among the contributing factors highlight overestimate of the ability of patient, dizziness, agitation, gloom, high bed and inadequate and / or difficult of handle bars. It is concluded that MFS is an important tool for evaluation of risk of falls and recommended the deploying of the same as a quality indicator of health care in the research institution. It is hoped that this study will serve as subsidy for health professionals, particularly the nursing staff to implement of strategies that prevent the occurrence of falls during the hospitalization.