OBJECTIVE: There is no published local data available on falls and fall-related injuries among hospitalized patients. This study aims to determine the incidence of falls, fall-related injuries and related risk factors at the surgical and medical wards of a tertiary government hospital in the Philippines.

METHODS: This is a cross-sectional study using consecutive sampling of patients admitted to the medical and surgical wards of a tertiary government hospital from May 2014 to April 2015. Data collection included the patients' demographic data, diagnosis, medications, details on the fall, consequence of the fall, and risk factors for the fall.

RESULTS: During the one-year period, 25,849 patients were admitted to the medical and surgical wards and only six patients, representing 0.02%, were reported to have sustained a fall. No major injury occurred. The patients had varied neurologic and/or musculoskeletal disorders. Two patients fell from a wheelchair, while one fell from a bedside chair. One patient fell from the bed and one slipped on the floor. All patients had watchers/witnesses at the time of the fall.

CONCLUSION: The incidence of falls and fall-related injuries is low in a local tertiary government hospital. No serious injury resulted from the falls. Prevailing practices, local cultural expectations and under reporting may have affected the relatively low incidence rates of patient falls reported in this study.

Human ; Male ; Female ; Accidental Falls ; Risk Factors ; Wheelchairs ; Hospitalization ; Data Collection ; Tertiary Care Centers ; Musculoskeletal Diseases

Objectives: The purpose of the study is to determine the level of rationing of nursing care and its relationship to nurses' perception of their practice environment.

Methods: The study employed a descriptive, cross-sectional study design. The Basel Extent of Rationing of Nursing Care (BERNCA) was administered to assess the level of care rationing while the Practice Environment Scale of the Nursing Work Index (PES-NWI) was used to describe nurses' practice environment. A total of 147 nurses participated in the study. Multiple regression analysis was conducted to determine the effect of various respondent characteristics and nurse practice environment on care rationing.

Results: Only practice environment total score was significantly associated with rationing of care total scores (B = -0.20, p < 0.05). Results of the regression show that for every unit increase in nurse practice environment total score, indicating a better work environment, there is a 0.20 unit decrease in rationing of nursing care total score, which indicated less rationing of care. Respondent characteristics are not significantly related.

Conclusion: Nurses most frequently rationed tasks in the areas of caring/support and monitoring. The less frequently rationed tasks involved medical, technical, and therapeutic aspects of care. The identification of rationing predictors can aid in determining starting points for hospital policy reforms. Prevalence levels can indicate when care rationing exceeds identified thresholds, if any. Nursing administrators can use implicit rationing of nursing care as a crucial indicator of the impact of strategies and changes in the nurse practice environment (e.g., changes in staffing levels, skill mix, and other resources).

Key Words: Health Care Rationing, Health Facility Environment, Nursing Care

Health Care Rationing ; Health Facility Environment ; Nursing Care