Measurement of Falls

A standardized inpatient fall rate calculation facilitates comparison of fall rates within and between healthcare facilities. According to Dunton, Gajewski, Taunton and Moore (2004) acute care facility fall rates average 3.73 per 1,000 patient days. The fall rate is usually reported as the number of falls reported by staff in one thousand patient days. Short stay units may have to calculate 24 hour occupancy to determine patient days.

Measure	Formula	Example
Fall rate	Patient falls x 1,000 Patient days	Unit falls for February Patient falls = 3 (14 occupied beds X 28 Days) = Patient days = 392 = 0.0076 X 1000 =7.6
Fall injury rate	Patient fall Injuries x 1,000 Patient days	Unit fall injuries in February Fall injuries = 1 (14 occupied beds X 28 Days) = Patient days = 392 = 0.00255 X 1000 = 2.55

Injuries associated with inpatient falls are important patient safety indicators. Falls that result in patient death or significant disability occurring while being cared for in a health care setting are reportable Joint Commission Sentinel Events.• Standardized reporting of inpatient fall injury is commonly characterized using National Database of Nursing Quality Indicators (NDNQI®) which include the following injury categories:

"None—patient had no injuries (no signs or symptoms) resulting from the fall, if an x-ray, CT scan or other post fall evaluation results in a finding of no injury.
Minor—resulted in application of a dressing, ice, cleaning of a wound, limb elevation, topical medication, bruise or abrasion.
Moderate—resulted in suturing, application of steri-strips/skin glue, splinting or muscle/joint strain.
Major—resulted in surgery, casting, traction, required consultation for neurological (basilar skull fracture, small subdural hematoma) or internal injury (rib fracture, small liver laceration) or patients with coagulopathy who receive blood products as a result of the fall.
Death—the patient died as a result of injuries sustained from the fall (not from physiologic events causing the fall)"•