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

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

Research output: Contribution to journalArticle

34 Citations (Scopus)

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 (US)
Pages (from-to)408-413
Number of pages6
JournalJoint Commission Journal on Quality and Patient Safety
Volume38
Issue number9
StatePublished - Jan 1 2012

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Odds Ratio
Wounds and Injuries
Confidence Intervals
Opiate Alkaloids
Intrinsic Factor
Wheelchairs
Electronic Health Records
Community Hospital
Serotonin Uptake Inhibitors
Diuretics
Antipsychotic Agents
Retrospective Studies
Logistic Models
Nurses
Interviews

All Science Journal Classification (ASJC) codes

  • Leadership and Management

Cite this

Mion, L. C., Chandler, A. M., Waters, T., Dietrich, M. S., Kessler, L. A., Miller, S. T., & Shorr, R. I. (2012). Is it possible to identify risks for injurious falls in hospitalized patients? Joint Commission Journal on Quality and Patient Safety, 38(9), 408-413.

Is it possible to identify risks for injurious falls in hospitalized patients? / Mion, Lorraine C.; Chandler, A. Michelle; Waters, Teresa; Dietrich, Mary S.; Kessler, Lori A.; Miller, Stephen T.; Shorr, Ronald I.

In: Joint Commission Journal on Quality and Patient Safety, Vol. 38, No. 9, 01.01.2012, p. 408-413.

Research output: Contribution to journalArticle

Mion, LC, Chandler, AM, Waters, T, Dietrich, MS, Kessler, LA, Miller, ST & Shorr, RI 2012, 'Is it possible to identify risks for injurious falls in hospitalized patients?', Joint Commission Journal on Quality and Patient Safety, vol. 38, no. 9, pp. 408-413.
Mion, Lorraine C. ; Chandler, A. Michelle ; Waters, Teresa ; Dietrich, Mary S. ; Kessler, Lori A. ; Miller, Stephen T. ; Shorr, Ronald I. / Is it possible to identify risks for injurious falls in hospitalized patients?. In: Joint Commission Journal on Quality and Patient Safety. 2012 ; Vol. 38, No. 9. pp. 408-413.
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