Is it possible to identify risks for injurious falls in hospitalized patients?

Lorraine C. Mion, A. Michelle Chandler, Teresa M. Waters, Mary S. Dietrich, Lori A. Kessler, Stephen T. Miller, Ronald I. Shorr

Research output: Contribution to journalArticlepeer-review

59 Scopus citations

Abstract

Background: Patient falls are among the most commonly reported adverse hospital events with more than one million occurring annually in the United States; approximately 10% result in serious injury. A retrospective study was conducted to determine predictors and outcomes of fall injuries among a cohort of adult hospitalized patients. Methods: Data were obtained regarding patients who sustained an initial fall in hospital during a 26-month period from 16 adult general medical and surgical units in an urban university-affiliated community hospital. Data on intrinsic (individual) factors, extrinsic (environmental) factors, and situational activities were collected via nurse and patient interviews, patient examinations, and audits of incident reports and electronic health records. Fall injuries were classi fied as none/any for analyses. Unadjusted odds ratios [ORs] and 95% confidence intervals [CIs] for each of the variables of interest with fall injury were generated using logistic regressions. Results: The 784 patients had a median age of 63.5 years (range, 20 to > 90 years), 390 (50%) were women, and 526 (67%) were black. Some 228 (29%) fallers sustained injury; patients who were white (OR: 2.23; 95% CI: 1.62, 3.08), or were administered a selective serotonin reuptake inhibitor (OR: 1.04; 95% CI: 1.04, 2.67), two antipsychotic agents (OR: 3.26; 95% CI: 1.20, 8.90), an opiate (OR: 1.59; 95%; CI: 1.14, 2.20), or a diuretic non-antihypertensive agent (OR: 1.53; 95% CI: 1.03, 2.26) were more likely to sustain an injury. Home-based wheelchair use was protective of fall injury (OR: 0.20; 95% CI: 0.05, 0.84). Seventy-nine percent of the patients had been designated as "high" fall risk within 24 hours before the fall. Conclusions: Few variables were able to distinguish patients who sustained injury after a hospital fall, further challenging clinicians' efforts to minimize hospital-related fall injury.

Original languageEnglish
Pages (from-to)408-413
Number of pages6
JournalJoint Commission Journal on Quality and Patient Safety
Volume38
Issue number9
DOIs
StatePublished - Sep 2012

Bibliographical note

Funding Information:
The work represented in this article was supported by a grant from the National Institute on Aging/NIH R01AG025285 .

ASJC Scopus subject areas

  • Leadership and Management

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