Influence of inpatient fall protocols on damage claims of health insurances against nursing homes in the german healthcare system

A central question in cases of legal liabilities with falls in nursing homes is the whereabouts of caregivers during a fall. A narrative analysis of 1,115 fall protocols showed a temporal association between the frequency maxima of the fall events and the shift changes. The study aimed to investigate the relationship between changes of nursing shifts and the incidence of falls according to age (chi-square test) in other nursing homes. There were 247 fall protocols for a supraregional nursing home operator analyzed. There was an overlap of the frequency maxima of falls in the morning between 7 and 8 a.m. During this time, 2 single and 23 multiple falls were recorded. There was a statistically significant difference in the fall numbers of different age groups. Most falls occurred in the age group of the 80 to 89-year old residents (n = 104). While the frequency maxima of falls, the shift changes took place in a room for all caregivers and then there were the basic care with the residents. This leads to the conclusion that caregivers at the time of the fall were not in the vicinity of affected residents. Due to a comprehensive risk assessment, a decrease of multiple falls at the same time of day for the same reason was conceivable. The fall analysis indicates a breach of duty for the nursing home owner. To reduce economic burdens for nursing homes by compensation claims and waste of resources in the German healthcare system, organizational procedures must be optimized.