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Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Point prevalence of suboptimal footwear features among ambulant older hospital patients: implications for fall prevention

Satyan R. Chari A B K , Prue McRae C , Matthew J. Stewart D , Joan Webster E F , Mary Fenn G and Terry P. Haines H I J
+ Author Affiliations
- Author Affiliations

A Safety and Quality Unit, Royal Brisbane and Women’s Hospital, Metro North Hospital and Health Service, Level 7, Block 7, Herston, Qld 4029, Australia.

B School of Primary Health, Faculty of Medicine, Nursing and Allied Health Sciences, Building H, McMahon Road, Monash University, Frankston, Vic. 3199, Australia.

C Safety and Quality Unit, Royal Brisbane and Women’s Hospital, Metro North Hospital and Health Service, Level 7, Block 7, Herston, Qld 4029, Australia. Present Address: Internal Medicine Research Unit, 7th Floor, UQ Health Sciences Building, Royal Brisbane and Women’s Hospital, Metro North Hospital and Health Service, Herston, Qld 4029, Australia. Email: prue.mcrae@health.qld.gov.au

D Department of Physiotherapy, Allied Health Services, Royal Brisbane and Women’s Hospital, Metro North Hospital and Health Service, Ned Hanlon Building, Herston, Qld 4029, Australia. Email: matthew.stewart@health.qld.gov.au

E Centre for Clinical Nursing, Royal Brisbane and Women’s Hospital, Metro North Hospital and Health Service, Herston, Qld 4029, Australia. Email: joan.webster@health.qld.gov.au

F School of Nursing and Midwifery, Queensland University of Technology, Kelvin Grove, Qld 4059, Australia.

G Patient Flow Unit, Lower Ground Floor, Ned Hanlon Building, Royal Brisbane and Women’s Hospital, Metro North Hospital and Health Service, Herston, Qld 4029, Australia. Email: mary.fenn@health.qld.gov.au

H Southern Clinical School, Physiotherapy Department, Monash University, Frankston, Vic. 3199, Australia. Email: terrence.haines@monash.edu

I Allied Health Research Unit, Kingston Centre, Monash Health, Warrigal Road, Cheltenham, Vic. 3192, Australia.

J School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Qld 4067, Australia.

K Corresponding author. Email: srcha5@student.monash.edu.au

Australian Health Review 40(4) 399-404 https://doi.org/10.1071/AH14168
Submitted: 24 September 2014  Accepted: 17 August 2015   Published: 12 October 2015

Abstract

Objective The aim of the present study was to establish the point prevalence of ‘suboptimal’ features in footwear reported to have been used by older hospital patients when ambulating, and to explore underpinning factors for their choice of footwear.

Method A cross-sectional investigation was undertaken on 95 of 149 eligible in-patients across 22 high fall-risk wards in a large metropolitan hospital in Brisbane, Australia.

Results Over 70% of participants experienced an unplanned admission. Although most participants had access to some form of footwear in hospital (92%), nearly all reported ambulating in footwear with ‘suboptimal’ features (99%). Examples included slippers (27%), backless slippers (16%) or bare feet (27%). For patients who ambulated in bare feet, only one-third reported ‘lack of access to footwear’ as the primary cause, with others citing foot wounds, pain, oedema and personal choice as the main reason for bare foot ambulation.

Conclusions Admitted patients frequently use footwear with ‘suboptimal’ features for ambulation in hospital. While some footwear options (for example well-fitting slippers) could be suited for limited in-hospital ambulation, others are clearly hazardous and might cause falls. Since footwear choices are influenced by multiple factors in this population, footwear education strategies alone may be insufficient to address the problem of hazardous footwear in at-risk patients. Footwear requirements may be more effectively addressed within a multidisciplinary team approach encompassing foot health, mobility and safety.

What is known about the topic? Accidental falls while ambulating are an important health and safety concern for older people. Because certain footwear characteristics have been negatively linked to posture and balance, and specific footwear types linked to falls among seniors, the use of footwear with fewer suboptimal characteristics is generally recommended as a means of reducing the risk of falling. While footwear usage and choices have been explored in older people in the community and in residential care settings, there is little comparable data on acutely unwell older hospital patients.

What does this paper add? This paper provides prevalence data on the use of footwear with suboptimal characteristics among ambulant older hospital patients, and identifies concurrent factors that may be relevant to patient footwear choices.

What are the implications for practitioners? Pain, foot pathology and a desire to retain independence are important concerns for hospitalised patients and are likely to influence their choice of footwear used to ambulate with. Pragmatic team-based approaches that remain sensitive to key patient concerns may be more successful in optimising patient footwear usage than footwear education strategies alone.


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