An Analysis of Falls and Those who Fall in a Chronic Care Facility

Chris A. McGibbon, Jeremy T. Slayter, Linda Yetman, Alexander McCollum, Rose McCloskey, Sharron G. Gionet, Heather Oakley, Pamela Jarrett

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Objectives: Falls in hospitals lead to adverse patient outcomes and prevention of falls is of upmost importance. Little is known about fall and injury rates in chronic care facilities, which are similar to skilled nursing facilities in the United States. Current fall risk tools in this setting are not well studied. Enhancing the understanding of how patient characteristics relate to fall circumstances is also needed. Design: Retrospective analysis of falls over 3 years on consecutive admissions and discharges. Setting and Participants: A 104-bed geriatric chronic care facility. Measures: Fall and injury data, descriptive data for patients measuring mobility, balance, cognition, function, and frailty in relation to risk of falls and fall circumstances were analyzed. Results: There were 1141 falls, with an overall fall rate of 8.48 falls per 1000 occupied bed days. The overall injury rate was 37.2 injuries per 100 falls. Being male and frail, having a mobility aid, poor mobility, balance, or cognition were associated with falling. Patients with good balance but poor cognition was more likely to fall outside their room, while those with poor mobility/balance fell more often in their room. The Clinical Frailty Scale performed modestly well at predicting falls with an odds ratio of 2.5 (95% confidence interval 1.9-3.2). Conclusions and Implications: Fall rates in chronic care facilities differ from what is reported in other settings. Patient characteristics such as male, use or misuse of a mobility aid, and poor cognition are more common in fallers. Fall circumstances differ in those with poor cognition compared with those with poor mobility and balance. More research focusing on frailty, cognition, and mobility/balance is needed to develop accurate tools that can predict those at a high risk of falls in these facilities.

Original languageEnglish
Pages (from-to)171-176
Number of pages6
JournalJournal of the American Medical Directors Association
Volume20
Issue number2
DOIs
Publication statusPublished - Feb 2019
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine

ASJC Scopus Subject Areas

  • General Nursing
  • Health Policy
  • Geriatrics and Gerontology

PubMed: MeSH publication types

  • Journal Article

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