title: Outcome of in-patient falls in hospitals with 100% single rooms and multi-bedded wards.
abstract: BACKGROUND
  Falls in hospital account for almost two-fifths of the patient safety incidents reported to the National Reporting and Learning System in U.K. Studies have suggested an increased incidence of falls in single-bedded hospitals.
  
  
  OBJECTIVE
  To compare the outcome of in-patient falls occurring in units with 100% single rooms (SRs) and multi-bedded wards (M-BWs). SAMPLING DESIGN AND METHODS: An observational study. Retrospective standard incident reporting data (DATIX) on in-patient falls and associated injury were obtained from both sites over 18 months each. There was no change in demographics, size and characteristics of population except change in the geography of new hospitals.
  
  
  RESULTS
  The total number of in-patient fall incidents reported over the 3 years was 1,749. The mean age of patients on M-BW and SR sites was 81.0 ± 2.4 (51.3% females) and 80.3 ± 10.3 (50.7% females), respectively. The mean incidence of falls/1,000 patient-bed days on M-BW and SR sites was 5.44 ± 4.76 and 15.82 ± 19.56, respectively (P < 0.01). Overall fracture incidence/1,000 patient-bed days on M-BW and SR sites was 0.07 ± 0.48 and 0.36 ± 1.52 (P < 0.01), respectively. The hip fracture incidence/1,000 patient-bed days on M-BW and SR sites was 0.04 ± 0.38 and 0.15 ± 1.00 (P < 0.01), respectively. One-year mortality from the date of first incident fall was lower in M-BWs (41.1%) compared with SRs (47.1%), but this is not significant (P = 0.12).
  
  
  CONCLUSIONS
  This observational study shows a significantly increased incidence of falls and fracture in a hospital design with SRs compared with a multi-bedded facility. Consideration should be given to increased incidence of falls and falls-related injury in SRs when deciding on the percentage of single-room provision in new hospitals to admit frail older adults.
authors.affiliation: Department of Geriatric Medicine, Ysbyty Ystrad Fawr, Ystrad Mynach, CF82 7EP Wales, UK.
authors.forename: Inderpal
authors.initials: I
authors.lastname: Singh
authors.affiliation: Department of Geriatric Medicine, Ysbyty Ystrad Fawr, Ystrad Mynach, CF82 7EP Wales, UK.
authors.forename: Justin
authors.initials: J
authors.lastname: Okeke
authors.affiliation: Academic Dermatologist, Aneurin Bevan University Health Board, Newport, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Edwards
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D005260:Female; D006272:Health Facility Environment / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D010362:Patients' Rooms / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology
keywords: ageing; fracture; in-patient falls; older people; single rooms