ED patient falls and resulting injuries

Area of Science:

• Emergency Medicine
• Patient Safety
• Healthcare Quality Improvement

Background:

• Hospital-acquired patient falls are common adverse events.
• Limited data exists on falls occurring specifically within emergency departments (EDs).
• This study evaluates the applicability of the Hendrich II Fall Risk Model in the ED setting.

Purpose of the Study:

• To assess the effectiveness of the Hendrich II Fall Risk Model in identifying high-risk patients who fall in the ED.
• To describe the characteristics of patients experiencing falls in the ED and the nature of their injuries.

Main Methods:

• Retrospective review of medical records for ED falls over a 2-year period.
• Collection of Hendrich II Fall Risk Model parameters, patient characteristics, fall circumstances, and injuries.
• Analysis of fall rates and injury types.

Main Results:

• 57 falls occurred, at a rate of 0.288 per 1000 patient visits.
• The Hendrich II Model identified only 37.5% of high-risk falls (score ≥ 5).
• Intoxication (19.6%) and sedating medications (19.6%) were noted; 64.3% of falls occurred in ED rooms.

Conclusions:

• The Hendrich II Fall Risk Model appears unreliable for predicting ED falls.
• Development of an ED-specific fall risk model is recommended.
• Factors like intoxication and sedating medication use should be considered in ED fall risk assessment.