title: Falls among adult patients hospitalized in the United States:  prevalence and trends.
abstract: OBJECTIVE
  The purpose of this study was to provide normative data on fall prevalence in U.S. hospitals by unit type and to determine the 27-month secular trend in falls before the implementation of the Centers for Medicare and Medicaid Service (CMS) rule, which does not reimburse hospitals for care related to injury resulting from hospital falls.
  
  
  METHODS
  We used data from the National Database of Nursing Quality Indicators (NDNQI) collected between July 1, 2006, and September 30, 2008, to estimate prevalence and secular trends of falls occurring in adult medical, medical-surgical, and surgical nursing units. More than 88 million patient days (pd) of observation were contributed from 6100 medical, surgical, and medical-surgical nursing units in 1263 hospitals across the United States.
  
  
  RESULTS
  A total of 315,817 falls occurred (rate = 3.56 falls/1000 pd) during the study period, of which, 82,332 (26.1%) resulted in an injury (rate = 0.93/1000 pd). Both total fall and injurious fall rates were highest in medical units (fall rate = 4.03/1000 pd; injurious fall rate = 1.08/1000 pd) and lowest in surgery units (fall rate = 2.76/1000 pd; injurious fall rate = 0.67/1000 pd). Falls (0.4% decrease per quarter, P < 0.0001) and injurious falls (1% decrease per quarter, P < 0.0001) both decreased over the 27-month study.
  
  
  CONCLUSIONS
  In this large sample, fall and injurious fall prevalence varied by nursing unit type in U.S. hospitals. Over the 27-month study, there was a small, but statistically significant, decrease in falls (P < 0.0001) and injurious falls (P < 0.0001).
authors.affiliation: Northwest Center for Outcomes Research in Older Adults, VA Puget Sound Health Care System, Seattle, Washington, USA.
authors.forename: Erin L D
authors.initials: EL
authors.lastname: Bouldin
authors.forename: Elena M
authors.initials: EM
authors.lastname: Andresen
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Dunton
authors.forename: Michael
authors.initials: M
authors.lastname: Simon
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Waters
authors.forename: Minzhao
authors.initials: M
authors.lastname: Liu
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Daniels
authors.forename: Lorraine C
authors.initials: LC
authors.lastname: Mion
authors.forename: Ronald I
authors.initials: RI
authors.lastname: Shorr
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000328:Adult; D006757:Hospital Units / Q000706:statistics & numerical data; D006760:Hospitalization; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D016013:Likelihood Functions; D008137:Longitudinal Studies; D015995:Prevalence; D019984:Quality Indicators, Health Care; D012016:Reference Values; D012044:Regression Analysis; D012052:Reimbursement, Incentive; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology