An epidemiological study of falls on integrated general medical wards.
Reducing falls in hospital requires an environmental as well as a patient-orientated approach. We studied patient and ward characteristics relating to falls in an acute setting. In a prospective open observational study, we examined fall characteristics in two nuclear designed wards (A and B) and a longitudinal ward (C). We recorded 63 falls among 1609 patients. Ward C had the most falls (31 vs 18/14; p = 0.01), fall positive days (29 vs 15/10; p = 0.002) and fallers (27 vs 13/12; p = 0.001; OR 2.54, CI--1.41-4.57). Ward C had a higher cumulative risk of falls (p = 0.006) and fall positive days (p = 0.003). Choice of ward was a significant independent risk factor for falls (p = 0.01) when controlled for age, sex, and diagnostic variation between the wards. Most falls were intrinsic (A 66.7%, B 64.2%, C 61.3%, p = 0.45). A significantly higher proportion of falls on ward C occurred by the bed (p = 0.04). Significant differences exist between the wards, and fall reduction programmes should identify and compensate for adverse ward-related factors to increase the effectiveness of patient-targeted fall risk assessments.
Vassallo
M
M
King s Mill Centre, Mansfield Road, Sutton-in-Ashfield, Notts NG17 4JL, UK.
Azeem
T
T
Pirwani
M F
MF
Sharma
J C
JC
Allen
S C
SC
D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000368:Aged; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010362:Patients' Rooms / Q000706:statistics & numerical data; D011446:Prospective Studies; D012307:Risk Factors