UNMC experts in falls document COVID impact

The COVID-19 pandemic resulted in prolonged and multiple stressors on the U.S. health care system – and in COVID-19 patients themselves. Many hospital quality indicators worsened during the pandemic, including falls. UNMC’s CAPTURE Falls team recently collaborated on a study, published in the Journal of Nursing Care Quality, to review data from 107 adult patients with COVID who fell while hospitalized between March 2020 and April 2021.

The study analyzed patient characteristics, fall circumstances and patient and organizational contributing factors.

“Every data point is a patient who actually fell,” said principal investigator Dawn Venema, PhD, associate professor in the UNMC College of Allied Health Professions Department of Health and Rehabilitation Sciences.

Why might COVID-19 be associated with increased falls? During the worst of the pandemic, hospital systems and the people who staff them were overwhelmed. There generally was less supervision and longer response time, thanks to the isolation required by a highly infectious virus and potentially deadly disease.

And physical and respiratory function could drop much more quickly than patients realized.

“Patients didn’t realize how sick they were,” Dr. Venema said. “They didn’t realize how serious an illness this was.”

Oxygen levels could drop dramatically after taking just a few steps across the room.

One of the takeaways of the study: “Respiratory concerns aren’t usually on the radar by the hospital staff as a fall risk factor,” Dr. Venema said. This realization also is germane for a handful of other illnesses.

Dr. Venema and the UNMC CAPTURE Falls team, including Victoria Kennel, PhD, assistant professor in the UNMC College of Allied Health Professions, and Anne Skinner, a former assistant professor in the college, collaborated with Amy Hester, PhD, and Patricia Quigley, PhD, nationally recognized nursing and patient safety experts. Christina Reames and Kellie Clapper, of the falls team at Nebraska Medicine, UNMC’s primary clinical partner on the front lines of COVID-19 research and patient care, were brought in, as well.

The study arose from a request, in late 2020, from Nebraska Critical Access Hospitals that worked with CAPTURE Falls for advice on reducing falls that may be related to COVID. Meanwhile, CAPTURE Falls team members had noticed increased reporting of falls, many thought to have been COVID-related.

Dr. Venema hoped Drs. Hester and Quigley might have some resources CAPTURE Falls could pass along to the Nebraska hospitals. “We basically cold called them,” she said. “That opened the door and started a conversation with them.”

That conversation turned into a collaborative search for answers. “Everybody was trying to figure out what we were dealing with,” Dr. Venema said. “Hospitals were trying to survive during this time.”

Their findings and recommendations are commonsense, in retrospect. “But now we have data to back it up,” Dr. Venema said.