To avoid nocturnal falls, nurses should screen elderly patients for nocturia (nocturnal urge to urinate) as standard upon admission to hospital. This is the conclusion of Veerle Decalf, nurse specialist and health scientist, on the basis of a partial study of his doctoral research.
Decalf studied a large number of falls in a Belgian hospital: 28% of incidents occurred during nightly visits to the toilet. Half of these patients received intravenous fluids. Nurses should be aware that the intravenous administration of fluids increases the risk of nocturia and therefore the risk of nocturnal falls.
Intermittent fluid administration
In elderly patients, they should assess and discuss whether continuous fluid administration can be converted to intermittent fluid administration. In another Decalf sub-study, it was found that the majority of patients who fell on a nightly toilet visit did not seek the assistance of a nurse.
” Discuss whether the application of moisture continues can be converted to intermittent ‘
It may not have been clearly explained that the patient had to call the night for this; In any case, this was not recorded in the administration of the risk of falls for the patients in the study. It’s also possible that patients underestimate their own risk of falling, be ashamed to ask for help, or don’t want to burden busy nurses.
Positive effect of antidepressants
Decalf’s research also showed that falls from the nighttime toilet were more common in internal medicine and surgery than in the rehabilitation department. Contrary to expectations, patients who took antidepressants fell less often, possibly because they continued to sleep better on their medications.
Sticker Veerle. Nocturnal symptoms of the lower urinary tract in the elderly. UZ Gent doctoral thesis, March 2021