title: Fall prevention and bathroom safety in the epilepsy monitoring unit.
abstract: Falls are one of the most common adverse events occurring in the epilepsy monitoring unit (EMU) and can result in significant injury. Protocols and procedures to reduce falls vary significantly between institutions as it is not yet known what interventions are effective in the EMU setting. This study retrospectively examined the frequency of falls and the impact of serial changes in fall prevention strategies utilized in the EMU between 2001 and 2014 at a single institution. Overall fall rate was 2.81 per 1000 patient days and varied annually from 0 to 9.02 per 1000 patient days. Both seizures and psychogenic nonepileptic events occurring in the bathroom were more likely to result in falls compared with events occurring elsewhere in the room. With initiation of increased patient education, hourly nurse rounding, nocturnal bed alarms, having two persons assisting for high fall risk patients when out of bed, and immediate postfall team review between 2001 and 2013, there was a trend of decreasing fall frequency; however, no specific intervention could be identified as having a particular high impact. In late 2013, a ceiling lift system extending into the bathroom was put in place for use in all EMU patients when out of bed. In the subsequent 15 months, there have been zero falls. The results reinforce both the need for diligent safety standards to prevent falls in the EMU as well as the challenges in identifying the most effective practices to achieve this goal.
authors.affiliation: Department of Neurology, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Spritzer
authors.affiliation: Department of Neurology, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Katherine C
authors.initials: KC
authors.lastname: Riordan
authors.affiliation: Department of Nursing, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Jennnifer
authors.initials: J
authors.lastname: Berry
authors.affiliation: Department of Nursing, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Bryn M
authors.initials: BM
authors.lastname: Corbett
authors.affiliation: Department of Nursing, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Joyce K
authors.initials: JK
authors.lastname: Gerke
authors.affiliation: Department of Neurology, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Hoerth
authors.affiliation: Department of Neurology, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Amy Z
authors.initials: AZ
authors.lastname: Crepeau
authors.affiliation: Department of Neurology, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Drazkowski
authors.affiliation: Department of Neurology, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Joseph I
authors.initials: JI
authors.lastname: Sirven
authors.affiliation: Department of Neurology, Mayo Clinic, Phoenix, AZ, USA. Electronic address: noe.katherine@mayo.edu.
authors.forename: Katherine H
authors.initials: KH
authors.lastname: Noe
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D061214:Patient Safety; D012189:Retrospective Studies; D012640:Seizures; D014741:Video Recording
keywords: Epilepsy; Epilepsy monitoring unit; Falls; Long-term video-EEG monitoring; Safety; Seizures