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Patterns and Predictors of Inpatient Falls and Fall‐Related Injuries in a Large Academic Hospital

Irene D. Fischer , MPH, Melissa J. Krauss , MPH, William Claiborne Dunagan , MD, Stanley Birge , MD, Eileen Hitcho , MS, Shirley Johnson , RN, MS, MBA, Eileen Costantinou , MSN, RN and Victoria J. Fraser , MD
Infection Control and Hospital Epidemiology
Vol. 26, No. 10 (October 2005), pp. 822-827
DOI: 10.1086/502500
Stable URL: http://www.jstor.org/stable/10.1086/502500
Page Count: 6
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Patterns and Predictors of Inpatient Falls and Fall‐Related Injuries in a Large Academic Hospital
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Abstract

OBJECTIVES.  Most research on hospital falls has focused on predictors of falling, whereas less is known about predictors of serious fall‐related injury. Our objectives were to characterize inpatients who fall and to determine predictors of serious fall‐related injury. METHODS.  We performed a retrospective observational study of 1,082 patients who fell (1,235 falls) during January 2001 to June 2002 at an urban academic hospital. Multivariate analysis of potential risk factors for serious fall‐related injury (vs no or minor injury) included in the hospital’s adverse event reporting database was conducted with logistic regression to calculate adjusted odds ratios (aORs) with 95% confidence intervals (CI95). RESULTS.  The median age of patients who fell was 62 years (interquartile range, 49–77 years), 50% were women, and 20% were confused. The hospital fall rate was 3.1 falls per 1,000 patient‐days, which varied by service from 0.86 (women and infants) to 6.36 (oncology). Some (6.1%) of the falls resulted in serious injury, ranging by service from 3.1% (women and infants) to 10.9% (psychiatry). The most common serious fall‐related injuries were bleeding or laceration (53.6%), fracture or dislocation (15.9%), and hematoma or contusion (13%). Patients 75 years or older (aOR, 3.2; CI95, 1.3–8.1) and those on the geriatric psychiatry floor (aOR, 2.8; CI95, 1.3–6.0) were more likely to sustain serious fall‐related injuries. CONCLUSIONS.  There is considerable variation in fall rates and fall‐related injury percentages by service. More detailed studies should be conducted by floor or service to identify predictors of serious fall‐related injury so that targeted interventions can be developed to reduce them.

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