Fall Management: Evaluation of Fall Events in an Inpatient Care Facility
Keywords:
Falling, fall protocol, risk of falling, prevention of falling, evaluation
Abstract
Introduction: Falls pose a significant risk to older people in nursing facilities. They can lead to serious health consequences, prolonged stays, and impaired quality of life. A systematic evaluation of falls can help identify causes and improve prevention strategies. Objective: The aim of this retrospective study was to analyze falls in a nursing facility over a three-year period. Methods: 290 documented falls were descriptively analyzed between 1 January 2021 and 31 December 2023. Results: The mean age of patients who experienced a fall was 81.26 years. A fall incidence of 5.21 falls per 1,000 patient cases was determined for the survey period. 142 males (48.96%) and 148 females (51.03%) fell. Most falls (68%) occurred in the patient room, particularly between 6:00 a.m. and 8:00 a.m., 4:00 p.m. and 6:00 p.m., while using the toilet, and while walking without assistive devices. The most frequently documented injuries were abrasions (n=45), 15.51%, and bruises. Significant risk factors identified included limited mobility, the use of assistive devices, unsuitable footwear, and a lack of accessibility. Conclusions: The results reveal important focal points for individual prevention measures. The targeted use of aids, an adapted environment, and supportive guidance in high-risk situations appears particularly effective.
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References
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37. Tideiksaar, R .(2008). Falls and Fall Prevention: Assessment, Prevention, Management, 2nd edition, Hans Huber Verlag, Bern. P 40.
38. Von Renteln-Kruse, W & Krause, T, 2004, Falls in inpatient geriatric patients – results of a 3-year prospective study, Journal of Gerontology and Geriatrics, vol. 37, pp. 9-14.
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41. World Health Organization (2015). WHO global report on falls prevention in older age 2007, World Health Organization, p. 1-47.
2. Balzer K, Bremer M, Schramm S, Dagmar L , Rasper H. Fall prevention in older people in their personal living environment (2012). Medical knowledge, HTA report. DOI: 10.3205/hta000099L.
3. Becker, C.; Lindemann, U.; Rißmann U. Fall prevention. Vincentz, Hannover, 2003.
4. Brand, C A, & Sundararajan, V. (2010). A 10-year cohort study of the burden and risk of in-hospital falls and fractures using routinely collected hospital data. BMJ Quality & Safety, qshc-2009, p.1-7.
5. Breimeier, H & Lohrmann, C, 2015. Research and knowledge transfer, Institute of Nursing Science, Implementation of the fall prevention guideline, Institute of Nursing Science, research report viewed 20.1.2016.https://static.uni graz.at/fileadmin/Unikid-Unicare/Dokumente/2011_Forschungsbericht_MUG.pdf.
6. Campbell AJ, Borrie MJ, Spears GF. Risk factors for falls in a community-based prospective study of people 70 years and older. J Gerontol A Biol Sci Med Sci 1989; 44: M112–M117.
7. Faust, V. (2012). Risk of falls in old age, recognizing, understanding, preventing, and treating mental disorders, Psychiatry today, viewed 22.1.2016. http://www.psychosoziale-gesundheit.net/pdf/Int.1-Sturz-Gefahr_im_Alter.pdf.
8. Ganz DA, Bao Y, Shekelle PG, Rubenstein LZ. Will my patient fall? JAMA 2007; 297: 77–86.
9. German Network for Quality Development in Nursing (ed.) Expert Standard for Fall Prevention in Nursing – 1st Update 2013, Publication Series of the German Network for Quality Development in Nursing. Osnabrück.
10. Gostynski M, Ajdacic-Gross V, Gutzwiller F, Michel J-P, Herrmann F. Epidemiological analysis of accidental falls by the elderly in Zurich and Geneva. Swiss Medical Weekly 1999; 129: 270-275.
11. Halfon, P. Eggli, Y. Van Melle, G. Vagnair, A. Risk of falls for hospitalized patients: a predictive model based on routinely available data, J Clin Epidemiol. 54 (2001) 1258 1266.
12. Heinze C, Dassen T. (2004). How many patients fall in German hospitals?. Die Schwester/Der Pfleger 2004; 43: 46–49.
13. Heinze C, Lahmann N, Dassen T. (2002): Frequency of falls in German hospitals. Gesundheitswesen 64 (11), 598–601.
14. Hill K D, Vu M, Walsh W. (2007): Falls in the acute hospital setting--impact on resource utilisation. Aust Health Rev 31 (3), 471–477.
15. Hitcho EB, Krauss MJ, Birge S, Dunagan WC, Fischer I, Johnson S, Nast PA, Costantinou E, Fraser VJ. Characteristics and circumstances of falls in a hospital setting. J Gen Intern Med [Internet]. 2004 Jul;19(7):732–9. Available from: http://link.springer.com/10.1111/j.1525-1497.2004.30387.x.
16. Huser,H.K.M. Many psychotropic drugs, many falls? A retrospective study of potential effects of psychotropic drugs on fall frequency in acute geriatrics. : https://doi.org/10.48549/5350.
17. International Council of Nursing (Hrsg) (2003). International Classif ication of nursing practice. Huber, Bern.
18. Kahl, S, Vogel, F.(2021). Key figures in nursing. Falls as a suitable quality indicator?! Military Medicine and Pharmacy 2021. https://wehrmed.de/humanmedizin/kennzahlen-in-der-pflege.html
19. Kinne V, Klewer J . (2016). Fall incidents in a university hospital. HeilberufeScience 7 (1), 40–46.
20. Klewer, J, Simke, K, Buttler, M . Fall management in inpatient care Article in Heilberufe. October 2008 DOI: 10.1007/s00058-008-1304.
21. Kobayashi, K, Imagama, S, Inagaki, Y, Suzuki, Y, Ando, K, Nishida, Y, ... & Ishiguro, N. (2017).Incidence and characteristics of accidental falls in hospitalizations”, Nagoya journal of medical science, vol.79, no. 3, p. 291-297.
22. Lee, J E, Stokic, D S. Risk factors for falls during inpatient rehabilitation. Archives of Physical Medicine and Rehabilitation 2008; 87(5): 341-350.
23. Leschke D, Klewer J. Evaluation of fall event protocols from a full-time nursing facility. August 2014. HeilberufeScience 5(3):88-92, DOI:10.1007/s16024-014-0222-3, 89.
24. Lohrmann, C (ed.) 2016, “Nursing Quality Survey 12 April 2016”, Institute of Nursing Science, Medical University of Graz.
25. López-Soto, PJ, Smolensky, MH, Sackett-Lundeen, LL, De Giorgi, A, Rodríguez Borrego, MA, Manfredini, R, ... & Fabbian, F .(2016). Temporal patterns of in hospital falls of elderly patients . Nursing research, vol. 65, no.6, p. 435-445.
26. Rapp, K, Becker, C, Cameron, ID, König, HH, & Büchele, G .(2012). Epidemiology of falls in residential aged care: Analysis of more than 70,000 falls from residents of bavarian nursing homes .Journal of the American Medical Directors Association, vol.13, no. 2, p. 187-e1.
27. Rapp, K., Ravindren, J.,Becker, C ., Lindemann,U., Jaensch, A., Klenk, J(2016). Fall risk as a function of time after admission to sub-acute geriatric hospital units, BMC Geriatr. 16. (2016) 173.
28. Sawetzki, S., Klewer J. Analysis of falls in a cardiology and cardiac surgery hospital. HeilberufeSCIENCE 2012; 3(4): 188–191.
29. Schlüter, S., Kupatz, P., Karas, M.(2016). Evaluation of falls in a musculoskeletal rehabilitation clinic – A contribution to fall prevention .German Medical Science 2016. doi: 10.3205/16altra07.
30. Schmid, AA, Wells, CK, Concato, J, Dallas, MI, Lo, AC, Nadeau, SE, ... & Struve, F.( 2010). Prevalence, predictors, and outcomes of poststroke falls in acute hospital setting.Journal of rehabilitation research and development, vol. 47, no. 6, p.553-560.
31. Schoberer, D, Findling, E, Uhl, C, Schaffer, S, Semlitsch B, Haas, W, Schrempf, S, Walder, M & Hierzer, A. (2012). Evidence Based Nursing, Fallprevention, 2. Updated Edition, University Hospital Graz.
32. Schwendimann, R, Bühler, H, De Geest, S, Milisen, K, 2008. Characteristics of hospital inpatient falls across clinical department. Gerontology, vol. 54, no.6, p. 342-348.
33. Schwendimann, R. Bühler, H. De Geest, S. Milisen, K. Falls and consequent injuries in hospitalized patients: effects of an interdisciplinary falls prevention program., BMC 47 Literaturverzeichnis Health Serv. Res. 6 (2006) 69.
34. Schwendimann,R. Frequency and circumstances of falls in acute care hospitals: A pilot study, Pflege 1998, p. 336.
35. Simke,J.,Buttler, M., Klewer,J. Fall management in inpatient care Results from the documentation of falling in two nursing homes. Article in Heilberufe • October 2008 DOI: 10.1007/s00058-008-1304
36. Strutz N, Kiselev J, Lahmann N. Predictors of falls in nursing homes: a cross-sectional study in Germany. HBScience (2020) 11:44–51 https://doi.org/10.1007/s16024-020-00340-w.
37. Tideiksaar, R .(2008). Falls and Fall Prevention: Assessment, Prevention, Management, 2nd edition, Hans Huber Verlag, Bern. P 40.
38. Von Renteln-Kruse, W & Krause, T, 2004, Falls in inpatient geriatric patients – results of a 3-year prospective study, Journal of Gerontology and Geriatrics, vol. 37, pp. 9-14.
39. Weber D, Klewer J: Falling of patients in an acute care hospital. Heilbe rufeSCIENCE 2010; 1(2): 36–39.
40. Wiedemann, A., Kirschner-Hermanns, R. & Jacobs, A. H. 2019. Urinary incontinence. In: Maetzler, W., Dodel, R. & Jacobs, A. H. (eds.) Neurogeriatrics: ICF-based diagnosis and treatment. Berlin, Heidelberg: Springer Berlin Heidelberg.
41. World Health Organization (2015). WHO global report on falls prevention in older age 2007, World Health Organization, p. 1-47.
Published
2025-11-12
How to Cite
Gurguri, A. (2025). Fall Management: Evaluation of Fall Events in an Inpatient Care Facility. European Scientific Journal, ESJ, 47, 39. Retrieved from https://eujournal.org/index.php/esj/article/view/20305
Section
ESI Preprints
Copyright (c) 2025 Arberesha Gurguri
This work is licensed under a Creative Commons Attribution 4.0 International License.
