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Challenges in Defining and Categorizing Falls on Diverse Unit Types: Lessons from Expansion of the NDNQI Falls Indicator

Staggs, Vincent S. PhD; Davidson, Jan MSN, APRN; Dunton, Nancy PhD, FAAN; Crosser, Brandon MA

doi: 10.1097/NCQ.0000000000000085

In 2012, the National Database of Nursing Quality Indicators launched a project to expand its falls indicator for use on pediatric, neonatal, and psychiatric units. We discuss challenges encountered, argue that schemes for categorizing falls by cause or supposed preventability are not suitable for large-scale efforts to track and prevent falls, express concern about the growing burden of collecting increasingly granular quality data, and discuss limitations of total and injurious fall rates as quality measures.

Department of Biostatistics (Dr Staggs) and School of Nursing (Drs Staggs and Dunton and Ms Davidson and Mr Crosser), University of Kansas Medical Center, Kansas City.

Correspondence: Vincent S. Staggs, PhD, Department of Biostatistics, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160 (

Authors received research funding under contracts with the American Nurses Association and Press Ganey Associates, Inc.

The authors report no other conflict of interest.

Accepted for publication July 18, 2014

Published ahead of print: September 3, 2014

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