[Falls in German hospitals and nursing homes 2006-2013. Frequencies, injuries, risk assessment, and preventive...

In Germany, a nationwide systematic collection of data regarding fall incidents within health-care facilities is lacking. The objective of the study was to provide valid and robust data on fall rates, the severity of the fall and its resulting injuries, fall risk assessment, and preventive measures offered by professional caregivers in German hospitals and nursing homes.

Each spring from 2006 to 2013, cross-sectional studies were conducted in 124 hospitals (n = 22,493 patients) and 332 nursing homes (25,384 residents) throughout Germany. Fully trained nurses obtained information on the recent history (< 14 days) of the fall and its consequences. Further, they assessed the individual fall risk by clinical judgment and recorded ongoing preventive measures.

The total fall rate was 3.9 % (95 % CI 3.6-4.2) in the hospitals and 4.6 % (95 % CI 4.3-4.9) in the nursing homes. Of the fall victims, 6.4 % of the nursing home residents and 8.8 % of the hospital patients were badly injured (i.e., fracture). The fall risk was considered high for residents, with two thirds of all residents being affected, while it was lower for the patients, at one third. The following factors were associated with fall risk: limited mobility, cognitive impairment, recent history of falls for nursing home residents, and additionally urinary incontinence and higher age in hospital patients. The most common preventive measure was counseling of the individual in both settings.

Although most falls have no severe consequences, the study shows that every 20-25th individual has a falling event in hospitals and nursing homes within 14 days. Despite the slight variance, the trend of the rates remains largely stable. Because specific fall risks were determined, preventive measures can be applied in a more personalized manner and care can be improved. Finally, the study provides valid and durable figures for national and international comparisons.