Top Five Physical Design Factors Contributing to Fall Initiation.

Area of Science:

• Healthcare facility design
• Patient safety research
• Human factors engineering

Background:

• Patient falls are a major healthcare concern.
• Limited research exists on the physical environment's role in falls.
• Intrinsic patient factors are well-studied, but extrinsic environmental factors require further investigation.

Purpose of the Study:

• To identify and prioritize physical design interventions for reducing patient falls.
• To analyze data from a completed study phase to inform design recommendations.
• To develop a prioritized list of physical design questions for fall prevention.

Main Methods:

• Analysis of 180 videos from a mock-up medical-surgical inpatient room.
• Use of generalized linear mixed effects models to examine posture-fall relationships.
• Identification of statistically significant physical design elements associated with fall-initiating postures.

Main Results:

• Specific patient postures (turning, pulling, pushing, bending, grabbing, sitting) were linked to fall initiation.
• Key physical design factors identified include bathroom door and spatial configuration, hardware, clinician zone space, and bedside spatial configuration.
• Obstructions resulting from spatial configurations around the patient bed were also significant.

Conclusions:

• Patient falls during unassisted ambulation can be reduced by addressing specific physical design elements.
• Prioritizing interventions related to bathroom and bedside physical attributes is recommended.
• Further research into the impact of the physical environment on patient mobility and safety is warranted.