 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Ingrid Connerney, DrPH1, F. Jacob Seagull, PhD2, Nancy Barczak, MS, RN3, Marc Oliver, RN, MPH4, Carla Middleton, RN, MS5, and Yan Xiao, PhD2. (1) Clinical Effectiveness, University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD 21201, 4103287700, iconnerney@umm.edu, (2) Anesthesia Research Lab, University of Maryland Medicine, 685 West Baltimore Street, Baltimore, MD 21201, (3) Risk Management, University Of Maryland Medical Center, 11 South Paca St, Baltimore, MD 21201, (4) Occupational Health Project, University of Maryland, 405 W. Redwood ST, Second Floor, Baltimore, MD 21201, (5) Professional Development, University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD 21201
Purpose: Falls are among the top leading causes of accidental deaths in the US and a major reason for elderly entering a nursing home. Falls among hospitalized patients are tracked by incidence reports. Falls are the most frequent reported incident, and often used as a measure of patient care. However, there is little published data on falls in the acute care setting. We studied factors associated with falls in a university hospital. Methods: Financial data were used to extract demographic information on all patients hospitalized at a university hospital in 2001. Patients who had fallen in the hospital were identified using incidence reports. Data were analyzed using descriptive statistics, chi-square to compare categorical variables, and t-test for continuous variables. Results: Sample included 30,395 patients. Average age was 41.8 years, 54% were male, and average length-of-stay was 6.1 days. There were 518 falls in 454 patients, an incidence rate of 2.9 per 1,000 patient days. The rate was 2.5/1,000 for experiencing first fall (454 patients), and 0.3/1,000 patient days for experiencing more than 1 fall (49 patients). A majority of patients have no injury when falling, but 15.6% of falls resulted in some injury (n=72, 0.4/1,000 patient days). Patients experiencing an injury were significantly older (average age 55 years vs. 42 years, p<.001) and had longer length-of-stay (average length-of-stay 21.2 days vs. 6.1 days; p<.001). Injury rate was significantly higher at age 60 and over (p<.001). No significant gender differences were seen. Fall rates vary by clinical service from 0.5 to 7.7/1,000 patient days. Falls occur most frequently in Geriatric Psychiatry (7.2/1,000 patient days), Neurology (6.8/1,000 patient days), and Cardiac Surgery (5.8/1,000 patient days). 50% of patients were found on the floor, 13% stated they had fallen. Falls occurred around the clock and did not vary significantly day or night. Falls were more likely to occur on a weekday (15.3%/day) compared to Saturday or Sunday (11.7%/day). Over 12 months, 9% (47) of falls occurred on day of admission, 8% (41) on day 1, and 11.8% (61) after 3 weeks in the hospital. Conclusion: The incidence rate for experiencing a first fall was 2.5 per 1,000 patient days, with the highest rates seen in Geriatric Psychiatry, Neurology, and Cardiac Surgery. Non-serious falls injury was significantly associated with higher age and longer hospital length-of-stay, but not with gender. Hospitals should consider their fall statistics to target risk-reduction strategies.
Learning Objectives:
Keywords: Hospitals, Quality of Care
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.