Fall Definitions and Categories

Definitions and categories enable users to communicate and compare more accurately. Unfortunately, there is no universally accepted definition of a patient fall. In fact, The Joint Commission allows each accredited facilities to determine what constitutes a patient or resident fall.

Some fall definitions are succinct; an event which results in a person coming to rest inadvertently on the ground or floor or other lower level (WHO, 2012).  Some are detailed; “loss of upright position that results in landing on the floor, ground or an object or furniture or a sudden, uncontrolled, unintentional, non-purposeful, downward displacement of the body to the floor/ground or hitting another object like a chair or stair” (VA National Center).

Others provide guidance; “fall” refers to unintentionally coming to rest on the ground, floor, or other lower level, but not as a result of an overwhelming external force (e.g., resident pushes another resident). An episode where a resident lost his/her balance and would have fallen, if not for staff intervention, is considered a fall. A fall without injury is still a fall. Unless there is evidence suggesting otherwise, when a resident is found on the floor, a fall is considered to have occurred (DHHS).

Fall categories by cause:

Falls categorized by effect:

Fall Injury classifications:

Standardized reporting of inpatient fall injury is commonly characterized using National Database of Nursing Quality Indicators (NDNQI®) which include the following injury categories:

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There is a universal definition of falls that all hospitals must use when reporting them.