-Original-

Incidence and Risk Factors for Inpatient Falls in an Academic Acute-care Hospital

Akihito Nakai^1,2, Masami Akeda^1,3 and Ikuno Kawabata²

¹Department of Injury Prevention and Quality Management, Tama-Nagayama Hospital, Nippon Medical School
²Department of Obstetrics and Gynecology, Tama-Nagayama Hospital, Nippon Medical School
³Nursing Department, Tama-Nagayama Hospital, Nippon Medical School

Objective: The aims of this study were to assess the frequency of inpatient falls and to evaluate potential risk factors in an academic hospital.
Methods: An electronic audit of the inpatient database at the Tama-Nagayama Hospital of Nippon Medical School from April 2004 through March 2005 was performed. Inpatient falls were registered regularly with incident reports submitted by nurses and other hospital employees discovering the fall. All inpatients were analyzed for potential risk factors using univariate and multivariate logistic regression analysis.
Results: Of the 8,537 patients, 109 (1.3%) fell. Multivariate logistic regression analysis showed that inpatient falls were significantly associated with a patient age of 51 to 70 years (odds ratio, 2.4; 95% CI, 1.3∼4.7) or of 71 to 90 years (odds ratio, 4.2; 95% CI, 2.4∼8.1); with a hospital stay of 15 to 21 days (odds ratio, 3.4; 95% CI, 1.6∼7.0), 22 to 28 days (odds ratio, 4.3; 95% CI, 1.8∼9.5), or 29 days or longer (odds ratio, 13.8; 95% CI, 8.3∼24.1); with admission to the surgery (odds ratio, 2.0; 95% CI, 1.1∼3.5), orthopedics (odds ratio, 2.5; 95% CI, 1.1∼4.9), neurosurgery (odds ratio, 3.0; 95% CI, 1.5∼5.9), or urology service (odds ratio, 3.9; 95% CI, 1.8∼8.2); and with no surgical procedure (odds ratio, 1.6; 95% CI, 1.0∼2.6).
Conclusions: The present study demonstrates that patient-related factors, such as age and length of stay, and treatment-related factors, such as no surgical procedure and admission to the surgery, orthopedics, neurosurgery, or urology service, are independent risk factors for inpatient falls. The results suggest that fall-prevention programs should target patients with these risk factors.

J Nippon Med Sch 2006; 73: 265-270

Keywords
inpatient fall, risk factors, academic hospital, incident, quality management

Correspondence to
Akihito Nakai, MD, Department of Obstetrics and Gynecology, Tama-Nagayama Hospital, Nippon Medical School, 1-7-1 Nagayama, Tama-City, Tokyo 206-8512, Japan
nakai-3@nms.ac.jp

Received, June 16, 2006
Accepted, August 10, 2006