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Most Frequently Observed Risk Factors for Adult Inpatient Injurious Falls in Hospitals

Tzeng, Huey-Ming PhD, RN, FAAN; Yin, Chang-Yi MA

doi: 10.1097/NUR.0b013e3182a87271
Feature Article

Purpose: This exploratory, multihospital, cross-sectional nurse survey identified the adult population group with the most frequently observed risk factors for injurious falls in acute hospital settings.

Methodology: The survey was conducted at 5 nonprofit health systems in the United States. A subset of the survey data from the main study was used in this analysis. The main study was conducted in 2011–2012 and included 560 registered nurses (RNs) from 68 units; it was published in the Journal of Nursing Care Quality in 2013. All the subjects from the main study were included in the present study. Factor analysis was conducted on 81 risk factor frequency items. We identified the group based on the ranking of the mean values for the frequency groups. The risk factor effective preventability items were also analyzed.

Results: We identified 24 most frequently observed risk factors and 3 most effectively preventable risk factors, which were all integral to each individual patient. Five of the most frequently observed risk factors were identified as physical-motor factors, 8 were identified as cognition factors, and 4 were demographic characteristics. None of the most frequently observed risk factors were related to medication. The 3 most preventable risk factors were demographic characteristics. For exploratory purposes, 1-way analysis of variance tests were used and show that statistically significant differences were present in the mean scores on some of the frequency scales and effective preventability scales across study health systems, acuity levels of the units, and unit types.

Conclusion/Application of the Study: Perceptions of RNs about the most frequently observed and the most effectively preventable risk factors were mostly inconsistent. Clinical nurse specialists and nursing administrators need to identify frequently observed risk factors on a regular basis. These findings need to be communicated with RN staff in a systematic way to prioritize interventions to prevent injurious falls.

Author Affiliations: Professor of Nursing and Associate Dean for Academic Programs, College of Nursing, Washington State University, Spokane (Dr Tzeng); and Professor, Department of History, Chinese Culture University, Taipei, Taiwan (Mr Yin).

The authors report no conflicts of interest.

Correspondence: Huey-Ming Tzeng, PhD, RN, FAAN, College of Nursing, Washington State University, PO Box 1496, Room 167, Spokane, WA 99210-1495 (

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins