A recent US study conducted by Guy Fragala* found that approximately 50% of falls resulting in injury from patients in long-term aged care came from falling while getting into bed, out of bed or simply being repositioned while in their beds.

 

Furthermore, it was found that the chance of a patient falling and receiving an injury from a 900mm wide bed was 51% while the chance of falling from a 1100mm wide bed was only 33%. In other words, the study showed there was a 36% reduction in falls when patients in aged care had wider beds. According to Fragala’s study, there is a solid case for investing in measures to reduce falls from beds in aged care. Solutions include patient lifters and other stand aids, but the solution most likely to make a difference is wider beds.

 

Falling Costs: The Case for Investment

The University of Otago conducted a study entitled Falling costs: the case for investment** and found that: In New Zealand, falls in aged care facilities are the most common and costliest cause of injury in older people and about 41 percent of these falls occur during transfers. Around 30 to 60 percent of people aged =65 years fall each year and 10 to 20 percent of these events result in injury such as hip fractures, hospitalisations or death. The study goes on to explain that when the elderly have falls in aged care facilities and hospitals, such events are traumatic and distressing for the older person, their family, and staff. Further to personal costs, there are substantial financial costs, particularly for ACC. For instance, in 2010/11, the cost for a hip fracture with three weeks in hospital was $47,000, and a hip fracture with complications and discharge to an aged residential care facility was $135,000, per case. When we cross-reference the Fragala figures with the Otago study, it becomes clear that in addition to personal wellbeing and health risks, falls pose a significant financial burden to the healthcare system. Containing the cost of healthcare is a major objective for New Zealand’s system, and reducing falls, particularly when getting into bed, out of bed, or being repositioned, offers opportunities for solutions in cost savings.

 

900mm vs 1100mm Wide Beds

Fragala found that approximately 50% of falls that occur in long-term-care involve falling from bed. In New Zealand, most beds in long-term-care facilities are only 900mm wide, significantly narrower than a standard consumer bed, which can range from 1100mm to 1850mm wide. A standard consumer bed is now 1100mm wide, rather than the traditional 900mm wide. If we accept the Fragala study would return similar results here, it becomes clear the large difference in bed width 900mm vs 1100mm (200mm) is very likely directly contributing to falls as patients are getting into or out of bed, when performing repositioning manoeuvres or reaching for objects.

 

Finding Solutions

In summary, aged care residents have approximately 51% chance of falling from a 900mm wide bed during a repositioning event. Testing and observations indicate this risk reduces exponentially as bed widths increase to 1100mm. In other words, a patient’s risk of falling from bed can be reduced by 36% simply by replacing 900mm wide bed with 1100mm wide bed. When making bed system selections, facilities should make the effort to seriously consider how to best match bed system design and function to the needs of their resident population, as having proper bed systems can help aged care facilities meet the objective of maintaining a safer environment while aiming for a higher quality of care.