Staggs Vincent S, Mion Lorraine C, Shorr Ronald I
Health Services and Outcomes Research, Children's Mercy Hospitals and Clinics, Kansas City, Missouri.
Department of Pediatrics, University of Missouri- Kansas City, Kansas City, Missouri.
J Am Geriatr Soc. 2015 May;63(5):983-7. doi: 10.1111/jgs.13387. Epub 2015 May 4.
To determine the proportion of variation in long-term fall rates attributable to variability between rather than within hospital units and to identify unit- and hospital-level characteristics associated with persistently low- and high-fall units.
Retrospective study of administrative data on inpatient falls. Eighty low-fall and 74 high-fall units were identified based on monthly rankings of fall rates. Unit- and hospital-level characteristics of these units were compared.
U.S. general hospitals participating in the National Database of Nursing Quality Indicators.
Nonsubspecialty medical units (n=800) with 24 consecutive months of falls data.
Monthly self-reported unit fall rates (falls per 1,000 patient-days).
An estimated 87% of variation in 24-month fall rates was due to between-unit differences. With the exception of patient-days, a proxy for unit bed size, low- and high-fall units did not differ on nurse staffing or any other unit or hospital characteristic variable.
There are medical units with persistently low and persistently high fall rates. High-fall units had higher patient volume, suggesting patient turnover as a variable for further study. Understanding additional factors underlying variability in long-term fall rates could lead to sustainable interventions for reducing inpatient falls.
确定长期跌倒率变化中可归因于医院各科室之间而非科室内部差异的比例，并识别与持续低跌倒率和高跌倒率科室相关的科室及医院层面特征。
对住院患者跌倒行政数据的回顾性研究。根据跌倒率的月度排名确定了80个低跌倒率科室和74个高跌倒率科室。比较了这些科室的科室及医院层面特征。
参与国家护理质量指标数据库的美国综合医院。
拥有连续24个月跌倒数据的非专科医疗科室（n = 800）。
每月自我报告的科室跌倒率（每1000患者日的跌倒次数）。
24个月跌倒率的变化中，估计87% 归因于科室之间的差异。除了患者日（科室床位规模的一个替代指标）外，低跌倒率科室和高跌倒率科室在护士配备或任何其他科室或医院特征变量方面没有差异。
存在跌倒率持续较低和持续较高的医疗科室。高跌倒率科室的患者量更大，这表明患者周转率是一个有待进一步研究的变量。了解长期跌倒率变化背后的其他因素可能会带来减少住院患者跌倒的可持续干预措施。
