Characteristics and circumstances of falls in a hospital setting: a prospective analysis.
OBJECTIVE
To describe the epidemiology of hospital inpatient falls, including characteristics of patients who fall, circumstances of falls, and fall-related injuries.


METHODS
Prospective descriptive study of inpatient falls. Data on patient characteristics, fall circumstances, and injury were collected through interviews with patients and/or nurses and review of adverse event reports and medical records. Fall rates and nurse staffing levels were compared by service.


METHODS
A 1,300-bed urban academic hospital over 13 weeks.


METHODS
All inpatient falls reported for medicine, cardiology, neurology, orthopedics, surgery, oncology, and women and infants services during the study period were included. Falls in the psychiatry service and falls during physical therapy sessions were excluded.


RESULTS
A total of 183 patients fell during the study period. The average age of patients who fell was 63.4 years (range 17 to 96). Many falls were unassisted (79%) and occurred in the patient's room (85%), during the evening/overnight (59%), and during ambulation (19%). Half of the falls (50%) were elimination related, which was more common in patients over 65 years old (83% vs 48%; P <.001). Elimination-related falls increased the risk of fall-related injury (adjusted odds ratio, 2.4; 95% confidence interval 1.1 to 5.3). The medicine and neurology services had the highest fall rates (both were 6.12 falls per 1,000 patient-days), and the highest patient to nurse ratios (6.5 and 5.3, respectively).


CONCLUSIONS
Falls in the hospital affect young as well as older patients, are often unassisted, and involve elimination-related activities. Further studies are necessary to prevent hospital falls and reduce fall injury rates.
Hitcho
Eileen B
EB
Department of Medicine, Washington University School of Medicine, St Louis, MO 63110, USA.
Krauss
Melissa J
MJ
Birge
Stanley
S
Claiborne Dunagan
William
W
Fischer
Irene
I
Johnson
Shirley
S
Nast
Patricia A
PA
Costantinou
Eileen
E
Fraser
Victoria J
VJ
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003710:Demography; D005260:Female; D006760:Hospitalization; D006784:Hospitals, Teaching / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D009738:Nursing Service, Hospital; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D000078329:Workforce