In-patient falls: what can we learn from incident reports?
ABSTRACT Background: a previous analysis of 12 months data from the National Reporting and Learning System offered useful insights on contributory factors for patient falls but was limited due to the small data set of free-text analysis (n = 400). A subsequent pilot study of 4,571 reports found an apparent difference in the contributory factors for patients described as having cognitive and physical impairments.
to analyse 3 years national incident data (2005-08) to further explore the contributory factors of in-patient falls.
a total of 20,036 reports (15% sample) were analysed by coding the free-text data field. Contributory risk factors were compared with the whole sample and explored with the Chi-squared and Fisher's exact tests.
data were reported about the degree of harm (100% of reports), (un)witnessed status of fall (78%), location (47%), patient activity (27%), physical impairment/frailty (9.5%) and cognitive impairment/confusion (9.2%). Less than 0.1% of reports provided data about dizziness, illness, vision/hearing, and medicines. Overall, patients were more likely to be harmed when away from the bed space, mobilising/walking and by falling from the bed when not intending to leave the bed.
this analysis explored incident reports at a level of detail not previously achieved. It identifies significant contributory factors for fall locations and activities associated with physical and cognitive characteristics.
- Canadian journal of public health. Revue canadienne de santé publique 76(2):116-8. · 1.02 Impact Factor
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ABSTRACT: During a 22-month period in 1981-82, 250 falls were recorded at a 152-bed acute care specialty hospital in a United States metropolitan area. Rates were highest for patients age 65 years and older and for patients admitted with mental disorders. Patients who had fallen once had a subsequent fall rate of 91.7 per 1,000 patients compared to an overall rate of 18.7 for first falls. Half the falls occurred in or enroute to the private bathroom attached to each room. Only three falls resulted in injury sufficient to prolong hospital stay.American Journal of Public Health 08/1985; 75(7):775-7. · 3.93 Impact Factor
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ABSTRACT: Many previous studies of reported patient accidents in hospital used the accident report forms as the only data source, without questioning their reliability and despite 80% of the accidents being unwitnessed. This paper reports on three studies using data from patient interviews, staff questionnaires, medical and nursing notes and the accident report forms. The studies confirm that falls amongst elderly patients are the most common type of patient accident. However, patients' and staff's versions of the event often differed widely. Accident reports are stated to be required for legal purposes, but they were often incomplete and unreliable. Patient accidents and safety are too important to remain marginalised to mere compliance with out-of-date regulations. A new, 'slim-line', more accurate but less time-consuming patient accident reporting system should be developed, for which improvement in patient safety is the main aim and legal considerations the secondary aim.The British journal of clinical practice 01/1994; 48(2):63-6.