Improving the capture of fall events in hospitals: combining a service for evaluating inpatient falls with an incident report system.

Journal of the American Geriatrics Society
Ronald I ShorrLori A Kessler

Abstract

To determine the utility of a fall evaluation service to improve the ascertainment of falls in acute care. Six-month observational study. Sixteen adult nursing units (349 beds) in an urban, academically affiliated, community hospital. Patients admitted to the study units during the study period. Nursing staff identifying falls were instructed to notify, using a pager, a trained nurse "fall evaluator." Fall evaluators provided 24-hour-per-day 7-day-per-week coverage throughout the study. Data on patient falls gathered by fall evaluators were compared with falls data obtained through the hospital's incident reporting system. During 51,180 patient-days of observation, 191 falls were identified according to incident reports (3.73 falls/1,000 patient-days), whereas the evaluation service identified 228 falls (4.45 falls/1,000 patient-days). Combining falls reported from both data sources yielded 266 falls (5.20 falls/1,000 patient-days), a 39% relative rate increase compared with incident reports alone (P<.001). For falls with injury, combining data from both sources yielded 79 falls (1.54 injurious falls/1,000 patient-days), compared with 57 falls (1.11 injurious falls/1,000 patient-days) filed in incident reports--a 28% increase (...Continue Reading

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