[Frequency and circumstances of falls in acute care hospitals: a pilot study]

Falls among (elderly) patients are common in institutional settings. Falls may lead to fright, pain, slight or severe injuries, they may increase the duration of the hospital stay, patient discomfort and affect the quality of life. We conducted a prospective study to evaluate the incidence of patient falls in a public hospital (300 beds) in the city of Zurich and to test a fall report form to assess patients after the event. 372 falls were reported during the 12 month evaluation period from 1996 to 1997 (6.7 falls per 1000 patient days) in 9 wards with 184 beds for patients requiring both acute care and/or longer term geriatric rehabilitation. 207 (56%) of the falls remained without detectable consequences, 6 (1.6%) of the patients suffered from serious (fracture), and 89 (24%) from slight injuries (contusions, abrasions, lacerations). Most of the falls (286) happened unattended in the patient rooms, 162 (44%) of the patients have been found disoriented, and only 60 (16%) were able to ambulate independently (without using a device or personal assistance). Almost 50% (182) of the falls occurred within ten days after admission. No peaks during the day in the time of falling were seen. The hospital management recommended the use of an official incident reporting from (fall-protocol) for all units since January 1998. The development of a hospital-wide fall prevention program is being prepared.