title: Falls on integrated medical wards.
abstract: BACKGROUND
  An effective approach to fall prevention should involve an assessment of environmental as well as patient-related characteristics.
  
  
  OBJECTIVE
  To study the effect of age and ward design on fall characteristics among medical inpatients.
  
  
  METHODS
  In a prospective open observational study over 1 year, we studied falls on three medical wards. Wards A and B are nuclear designed, and C is longitudinal.
  
  
  RESULTS
  We recorded 199 falls involving 167 fallers. Fifty-four (27.1%) involved patients under 65 years. Most falls were intrinsic (60.8%) and involved elderly male patients (male/female ratio 97/48 vs. 24/30; p = 0.009). We identified no age differences in relation to location, activity, preceding fall, classification, time, consequences, and intervention required. On ward C, most falls occurred in the bed areas (bays and cubicles), but on wards A and B a higher proportion occurred in bathroom, corridor, and dayroom (C vs. A/B 87.9 vs. 73.7/62.0%; p = 0.04/p = 0.004). On ward C, activities of daily living around the bed significantly preceded falls (C vs. A/B 44.6 vs. 25.9/24.1%; p = 0.03/p = 0.01). Most falls were unwitnessed (C vs. A/B 10 vs. 21/20; p = 0.002/p = 0.0009).
  
  
  CONCLUSIONS
  Intrinsic falls are the commonest; however, differences exist in fall demographics between wards, and this must be recognized to enhance the effectiveness of fall prevention programmes.
authors.affiliation: Department of Medicine, King's Mill Centre, Sutton-in-Ashfield, UK.
authors.forename: M
authors.initials: M
authors.lastname: Vassallo
authors.forename: R A
authors.initials: RA
authors.lastname: Amersey
authors.forename: J C
authors.initials: JC
authors.lastname: Sharma
authors.forename: S C
authors.initials: SC
authors.lastname: Allen
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection; D005260:Female; D006748:Hospital Departments / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D011336:Probability; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D006113:United Kingdom / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology