Incidence and Risk Factors for Inpatient Falls in an Academic Acute-care Hospital

Nakai, Asami; Akeda, Masami; Kawabata, Ikuno

doi:10.1272/jnms.73.265

Cited by 53 publications

(42 citation statements)

References 21 publications

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“…13,[32][33][34][35][36] Less consistency is seen with other traditional risk factors such as age, sedating medication, and length of stay. 5,13,32,[36][37][38] Attempting to risk-stratify patients using simple and accurate assessment tools developed from these risk factors has proven to be very difficult. Many tools have been developed based on identified risk factors, but perform very poorly when trying to identify patients who will fall with reasonable specificity and positive predictive value.…”

Section: Dibardino Et Al |mentioning

confidence: 99%

“…[2][3][4][5][6][7] Inpatient falls remain a main focus of patient safety and a measure of quality in this era of healthcare reform and quality improvement. 8 Inpatient fall rates per 1000 patientdays range from 1.4 to 18.2.…”

mentioning

confidence: 99%

“…4,9 The absolute percentage of inpatients that fall ranges from 1.3% to 7%. 4,5,9,10 Of inpatient falls, almost all data suggest that roughly one-third result in some type of injury while 3%-8% result in serious injury or death. 9,[11][12][13] Fall prevention interventions have largely been aimed at modifiable risk factors such as getting out of bed with bed alarms, toileting needs with bedside commodes, and reducing delirium through reorientation techniques.…”

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confidence: 99%

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Meta‐analysis: Multidisciplinary fall prevention strategies in the acute care inpatient population

DiBardino

Cohen

Didwania

2012

Journal of Hospital Medicine

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BACKGROUND:Inpatient falls are common adverse events that lead to inpatient injury, increased length of stay, healthcare costs, litigation, and are a focus of patient safety and healthcare quality. Fall prevention methods are currently evolving to address the problem.PURPOSE:To examine the available data evaluating multidisciplinary fall prevention strategies in the acute inpatient setting.DATA SOURCES:A complete literature search of MEDLINE, CINAHL, EMBASE and the Cochrane Library through December 2011 was used. The bibliographies of all systematic reviews and meta‐analyses were hand searched.STUDY SELECTION:Only primary research studies relating to acute care inpatient hospital multidisciplinary fall prevention were included. Selected papers were assessed for quality by 2 authors using a 20‐point scale previously used in the fall literature.DATA EXTRACTION:Each selected study was carefully hand searched by 2 authors for the purposes of data extraction. Study results, in fall rate per 1000‐patient days, and the characteristics of the interventions used were extracted for analysis.DATA SYNTHESIS:Effect sizes (odds ratios) and 95% confidence intervals were derived for individual studies and then combined across research reports using a random‐effects meta‐analysis.CONCLUSIONS:Fall prevention strategies have a significant but small effect on fall rates despite the use of complex, multidisciplinary interventions. Additional randomized trials are needed to examine the possible benefits of multidisciplinary fall prevention strategies in the acute inpatient setting. Journal of Hospital Medicine 2012; © 2012 Society of Hospital Medicine

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Section: Dibardino Et Al |mentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Meta‐analysis: Multidisciplinary fall prevention strategies in the acute care inpatient population

DiBardino

Cohen

Didwania

2012

Journal of Hospital Medicine

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“…[2][3][4][5] As a result, inpatient falls have become a major priority for hospital quality assurance programs, and hospital risk management departments have begun to target inpatient falls as a source of legal liability. [1][2][3]6,7 Recently, the Centers for Medicare and Medicaid Services announced that it will no longer pay for preventable complications of hospitalizations, including falls and fallrelated injury. 8 Much of the literature on falls comes from community and long-term care settings, and only a few studies have investigated falls during acute care hospitalization.…”

Section: Abstract: Fall Prevention Injury Inpatient Fallsmentioning

confidence: 99%

Predictors of serious injury among hospitalized patients evaluated for falls

Bradley

Karani

McGinn

et al. 2010

Journal of Hospital Medicine

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BACKGROUND:Inpatient falls are common and result in significant patient morbidity.OBJECTIVE:To identify predictors of serious injury being found on imaging studies of inpatients evaluated after a fall.DESIGN:Retrospective study.SETTING:An 1171‐bed urban academic medical center.PATIENTS:All inpatients who fell on thirteen medical and surgical units from January 1 to December 31, 2006.MEASUREMENTS:Patient characteristics, circumstances surrounding falls, fall‐related injuries, and length of stay were collected through review of incident reports and computerized medical records. Primary outcome of fall‐related injury was determined by evidence of injury on imaging studies within two weeks of the fall. Univariate and multivariate logistic regression were used to calculate adjusted odds ratios (ORs) for injury after an inpatient fall.RESULTS:A total of 513 patients had 636 falls during the study time period. Fall incidence rate was 1.97 falls per 1,000 patient days. 95 patients (19%) fell multiple times (range, 2‐6 events); 74% of the falls occurred in patients who were previously assessed as being “at risk” by the nursing staff. Multivariate analysis, adjusting for age and sex, found evidence of trauma after a fall (OR = 24.6, P < 0.001) and ambulatory status (OR = 7.3, P < 0.01) to be independent predictors of injury being found on imaging studies.CONCLUSIONS:Inpatient falls are common despite high‐risk patients being identified. After adjusting for age and sex, evidence of trauma and ambulatory status were independent predictors of an injury being found on imaging studies after an inpatient fall. Journal of Hospital Medicine 2010;5:63–68. © 2010 Society of Hospital Medicine.

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“…Falls are a very common type of inpatient accident (ANARI, 2004;Nakai et al, 2006) and with their physical and psychological consequences might compromise an already impaired functional status or cause severe morbidity and mortality in old people (Rubenstein and Josephson, 2006). The incidence of falls rises steadily from middle-aged people and peaks in those who are over 80 years (Rubenstein and Josephson, 2002).…”

Section: Introductionmentioning

confidence: 99%

Predictors of falls and hospitalization outcomes in elderly patients admitted to an acute geriatric unit

Corsinovi

Aimonino

et al. 2009

Archives of Gerontology and Geriatrics

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Incidence and Risk Factors for Inpatient Falls in an Academic Acute-care Hospital

Cited by 53 publications

References 21 publications

Meta‐analysis: Multidisciplinary fall prevention strategies in the acute care inpatient population

Meta‐analysis: Multidisciplinary fall prevention strategies in the acute care inpatient population

Predictors of serious injury among hospitalized patients evaluated for falls

Predictors of falls and hospitalization outcomes in elderly patients admitted to an acute geriatric unit

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