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Falls in an Inpatient Geriatric Psychiatric Population

Hartford Hospital/Institute of Living, Hartford, Connecticut, eblair{at}harthosp.org, ejwblair{at}aol.com

Cynthia Gruman

University of Connecticut Health Center, Center on Aging, Farmington

BACKGROUND: Falls are a major health care concern for older adults in hospital settings. The incidence of falls on psychiatric units tends to be higher than that on general acute care hospital units, with estimated rates of 13.1 to 25 per 1,000 inpatient days compared to 3 to 5 per 1,000 inpatient days, respectively. OBJECTIVE: The purposes of this study were to quantify the number and types of falls and identify the associated risk factors relevant to a psychiatric inpatient setting. DESIGN: This was a descriptive study. Data were collected over a 6-month time period. Patients on a 28-bed acute care geriatric psychiatric unit provided the sampling frame. RESULTS: Twenty-eight patients fell during the study period for a total 45 falls. Six patients experienced multiple falls during their stay. Most of the falls that occurred did not result in serious injury. Individuals who experienced a fall were about 3 years older than nonfallers (73.6 years versus 76.36 years). There was no difference by gender as to rate of falls. Activity level was higher for the patients who had a fall, and medication had the strongest relationship to a falls episode. When census was low, the fall rate was slightly higher. CONCLUSIONS: There are many variables that contribute to the phenomenon of falls in an acute geriatric psychiatric inpatient unit. Use of research findings will allow the development of a fall risk prevention protocol to provide the safest environment and best quality of care possible for the geriatric patient.

Key Words: falls • fall prevention • geriatric psychiatric patients

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