‘Patient unable to express why he was on the floor, he has aphasia.’ A content thematic analysis of medical records and incident reports on the falls of hospital patients with communication disability following stroke

Newly published open access! 

https://onlinelibrary.wiley.com/doi/10.1111/1460-6984.12916

TLDR: Difficulties following instructions, communicating basic needs & gaining staff attention were contributing factors to falls. Patients fell when taking a risk or trying to meet a basic need. Communication disability complicated assessment for injury post fall. Clinical implications: Including speech pathologists in falls risk assessment, management, and prevention strategies may provide crucial information regarding the patient's communication disability that may enhance their fall prevention plan.


Participants and Communication Disabilities:

The study involved a review of the medical records and incident reports of 72 participants with communication disabilities, the majority of which had severe or profound communication disabilities.

Risk Factors for Falls:

The study identified difficulties following instructions as a risk factor for falls in 13.9% of participants.

Specific Falls Prevention Strategies for Communication Disabilities:

There were limited strategies noted specifically to mitigate the risk of communication disability. 

Contributing Factors for Falls:

Difficulties following instructions, communicating basic needs and gaining the attention of staff were noted to be contributing factors for falls. 

Falls Incidents:

There were four main circumstances of falls experienced by patients: attempting to address an unmet need, taking a risk, difficulties following instructions, and falls in unknown circumstances due to the fall being unwitnessed and the patient being unable to describe the fall due to the severity of their communication disability.

Outcomes After Falls:

Assessing patients for injuries following falls was challenging, especially for those with severe communication disabilities. Implementing further falls prevention strategies for patients experiencing multiple falls was difficult.

In conclusion, falls among patients with communication disabilities present unique challenges and require a more inclusive approach to falls prevention, with speech pathologists potentially playing a crucial role in optimising communication and reducing falls risk. Further research and the development of tailored interventions are necessary to address the specific needs of this population.

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