Fall Injuries and Related Factors of Elderly Patients at a Medical Center in Taiwan

Background: Elderly patients have a high incidence of falls and injuries in hospitals due to various reasons. The aims of this study were to explore the characteristics and factors associated with fall injuries among elderly patients. Methods: A retrospective survey study was conducted. Data were retrieved from the patient safety reporting system of a medical center in Taiwan query for patient fall incidents of elderly patients aged 65 years or older between 2010 and 2012. Statistics were computed and analyzed with percentages, variances, and logistic regression. Results: 378 elderly patient falls occurred during the 3-year period, a prevalence rate of 48.8%. The demographics of fall incidents were: 55.5% of male patients, 68.5% of patients in the high-risk group, 8.7% of repeat falls from previous year, 84.4% of patients were alert, 45.2% at night shifts, 28.6% at bedside, and 48.2% of patients accompanied. The severity and causes of fall injuries were: 269 falls resulted in injury (71.2%); the majority of the injuries were mild (56.3%), in which 30 were head injuries (7.9%); factors associated with fall injuries were of physical or behavioral conditions (73.4%), medication (8.4%), personal (7.6%), environment (7.1%), and facility or equipment (3.5%). The calculated odd ratios (OR) for predictors were: high-risk group (OR: 1.770), fall history (OR: 0.438), hotspots for falling (OR: 0.789), frailty (OR: 2.235), unsteady gait (OR: 2.235), weakened lower limbs (OR: 0.328), and high-risk patients insisting on unassisted movement (OR: 0.449). Conclusion: Fall injuries have a negative and serious impact on elderly patients to their health condition and quality of life. Nursing staff need to instruct fall prevention measures at an early stage of elderly patient hospitalization. This study should provide a reference for nursing staff in assessing fall risks and reducing resultant falls and injuries among elderly patients.