Analysis of Inpatient Falls to Improve Prevention Strategies

Inpatient fall prevention is a patient safety goal for hospitals highlighted in government healthcare agencies' publications and explored by researchers (Agency for Healthcare Research and Quality [AHRQ], 2019). The 2020 Hospital National Safety Goals include the most crucial factor for inpatient fall prevention that is to hear and respond to alarms on medical equipment on time (The Joint Commission, 2020). According to AHRQ, about 700,000 to one million falls occur in hospitals every year. One-third of inpatient falls result in injuries such as fractures and head trauma (AHRQ). As of 2017, AHRQ reports that the additional costs associated with inpatient falls are estimated to range from $2,680 to $15,491. Hospitals do not receive reimbursements from the Centers for Medicare & Medicaid Services (CMS, 2020) for costs associated with preventable falls. Therefore, the CMS provides incentives for hospitals to prevent falls. The large urban healthcare center's goal for the inpatient total fall rate is less than 3.00 fall per 1,000 occupied patient days. The fall rates for acute medical-surgical units were 3.67 to 6.26 falls per 1,000 occupied bed days in the U.S. based on studies published in 2014 (Cuttler, Barr-Walker, & Cuttler, 2017). Hospitals calculate the fall rate as the number of injurious falls per 1,000 occupied bed days (AHRQ, 2018). The large urban healthcare center (further referred to as the healthcare center) inpatient total fall rate has been hovering around 3.00 or below but sometimes above the goal of 3.00. This rate includes the fall rates from acute care, critical care, women & children units, and psychiatry. The healthcare center inpatient total fall rate is less when compared to other hospitals that have medical-surgical units. However, its organizational goal is to continue decreasing the inpatient overall fall rate that corresponds with a National Safety Goal for fall prevention. Numerous factors are contributing to patient falls in hospitals. Healthcare organizations use fall risk assessment tools, devices that alert providers about possible falls, and interventions to reduce the influence of these factors.