Patient Safety and Quality

Age, gender, and location are keys to predicting patient fall injuries in hospitals

Studies have suggested that serious injuries after a fall in a hospital can increase patient charges by about $4,000. A new study by Washington University School of Medicine researchers suggests hospitals keep close watch on older and female patients in bathrooms and patient care areas if they hope to quell the injuries that occur when patients fall.

The researchers studied 7,082 patient falls that occurred in 9 Midwestern hospitals of varying sizes, missions, and populations from 2001 to 2003. They found that patients were not harmed after more than half of the falls. However, 26.4 percent of patient falls resulted in some sort of injury, ranging from minor to major.

Most of the falls reported for the nine hospitals were unassisted, that is, no staff member was present to help break the fall. Unassisted falls tended to lead to injury. Injuries also ensued when falls occurred in bathrooms or in areas such as nurses' stations, hallways, and examination and treatment rooms.

Women who fell were not likely to be injured; however, if they were injured, their injuries were serious. Though all nine of the hospitals used the same fall reporting system, the researchers found variation in fall definitions. The team recommends standardizing definitions in systems that report patient falls, so research efforts can zero in on risk factors. They also suggest that if hospitals want to know how to prevent falls, their fall reporting systems should collect more descriptive information, including the patient's name, the hospital unit, location, a description of the fall, and the outcome.

This study was funded in part by the Agency for Healthcare Research and Quality (HS11898).

See "Circumstances of patient falls and injuries in 9 hospitals in a Midwestern healthcare system," by Melissa J. Krauss, M.P.H., Sheila L. Nguyen, M.P.H., William Claiborne Dunagan, M.D., and others in the May 2007 Infection Control and Hospital Epidemiology 28(5) pp. 544-550.

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