Mise en place d'un Programme d'Assurance de la Qualite afin de prevenir les chutes de personnes hospitalisees dans un etablissement de soins de suite et de readaptation

The aim of this study was to identify, in the context of a quality assurance program, the preventive measures which would be of benefit to hospitalized patients who risk falls in a follow-up and reeducation care establishment. Method: The program consists of 2 phases: a diagnostic phase designed to determine the circumstances in which falls occurred using 2 surveys, one retrospective, quantifying the adverse event, and the other prospective, precisely documenting 53 cases of falls; on the basis of the conclusions thus obtained the next phase consisted in compiling recommendations to be circulated through the hospital. Results: All frequency was high in our population (17.8% of patients). Etiologic analysis showed equivalent proportions of medical and organizational causes of the falls. Even though the two categories of cause are interdependent, distinguishing between them enables the broad lines of' the recommendations to be structured. Discussion: Study of the causes of falls sheds new light on how to prevent falls. In certain cases, the patients' characteristics make falls inevitable. However, unexploited potential for prevent on lies in the organization set up to manage hospitalized patients. In this context, the proposed recommendations do not aim to achieve an illusory objective of the 'zero fall' type, but instead are designed to reduce the avoidable falls and to attenuate the consequences of the non-avoidable falls while placing the accent on new forms of organization.