Multilevel factors influencing falls of patients in hospital: The impact of nurse staffing

J Nurs Manag. 2019 Jul;27(5):1011-1019. doi: 10.1111/jonm.12765. Epub 2019 May 14.

Abstract

Aim: The objective of this study was to investigate both individual and organizational factors influencing the falls of patients in hospitals.

Background: Falls and fall-related injuries, which cause health problems and increase the economic burden to patients, are a critical issue for patient safety.

Methods: This study retrospectively reviewed patient data and analysed factors influencing patient falls using a mixed-effect model.

Results: The total number of patients in the study was 60,049, and the characteristics of the patients showed statistically significant differences according to the type of hospital where the fall occurred. The average rate of falls was 0.92 per 1,000 days. The rate of falls in general hospitals was the highest among all hospitals. Age, mobility impairment and hours per patient day for care delivered by registered nurses were factors influencing patients' falls.

Conclusion: Since the number of patient falls in an acute-care setting might increase in the future because of the growing elderly population, we should consider these risk factors for falls and construct preventative programs accordingly.

Implications for nursing management: An adequate level of nursing staff is an essential factor in the number of patient falls.

Keywords: hospitals; nurse staffing; patient falls; patient safety.

MeSH terms

  • Accidental Falls / statistics & numerical data*
  • Analysis of Variance
  • Chi-Square Distribution
  • Hospitals / standards
  • Hospitals / statistics & numerical data
  • Humans
  • Nurses / statistics & numerical data
  • Nurses / supply & distribution
  • Personnel Staffing and Scheduling / standards*
  • Personnel Staffing and Scheduling / statistics & numerical data
  • Quality Indicators, Health Care / statistics & numerical data
  • Republic of Korea
  • Retrospective Studies