Consistent Differences in Medical Unit Fall Rates: Implications for Research and Practice
- Autores: Vincent S. Staggs, Lorraine Mion, Ronald I. Shorr
- Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 63, Nº. 5, 2015, págs. 983-987
- Idioma: inglés
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Resumen
Objectives To determine the proportion of variation in long-term fall rates attributable to variability between rather than within hospital units and to identify unit- and hospital-level characteristics associated with persistently low- and high-fall units.
Design Retrospective study of administrative data on inpatient falls. Eighty low-fall and 74 high-fall units were identified based on monthly rankings of fall rates. Unit- and hospital-level characteristics of these units were compared.
Setting U.S. general hospitals participating in the National Database of Nursing Quality Indicators.
Participants Nonsubspecialty medical units (n = 800) with 24 consecutive months of falls data.
Measurements Monthly self-reported unit fall rates (falls per 1,000 patient-days).
Results An estimated 87% of variation in 24-month fall rates was due to between-unit differences. With the exception of patient-days, a proxy for unit bed size, low- and high-fall units did not differ on nurse staffing or any other unit or hospital characteristic variable.
Conclusion There are medical units with persistently low and persistently high fall rates. High-fall units had higher patient volume, suggesting patient turnover as a variable for further study. Understanding additional factors underlying variability in long-term fall rates could lead to sustainable interventions for reducing inpatient falls.
