Determinants of hospital fall rate trajectory groups: A longitudinal assessment of nurse staffing and organizational characteristics

    Authors

    D. Everhart; J. R. Schumacher; R. P. Duncan; A. G. Hall; D. F. Neff;R. I. Shorr

    Comments

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    Abbreviated Journal Title

    Health Care Manage. Rev.

    Keywords

    Hospitals; magnet status; nursing staffing; patient falls; PATIENT FALLS; DEVELOPMENTAL TRAJECTORIES; PREVENTING FALLS; ACUTE-CARE; OUTCOMES; QUALITY; METAANALYSIS; ASSOCIATION; INJURIES; SAFETY; Health Policy & Services

    Abstract

    Background: Patient falls in acute care hospitals represent a significant patient safety concern. Although cross-sectional studies have shown that fall rates vary widely between acute care hospitals, it is not clear whether hospital fall rates remain consistent over time. Purpose: The aim of this study as to determine whether hospitals can be categorized into fall rate trajectory groups over time and to identify nurse staffing and hospital characteristics associated with hospital fall rate trajectory groups. Methodology/Approach: We conducted a 54-month (July 2006-December 2010) longitudinal study of U.S. acute care general hospitals participating in the National Database for Nursing Quality Indicators A (2007). We used latent class growth modeling to categorize hospitals into groups based on their long-term fall rates. Nurse staffing and hospital characteristics associated with membership in the highest hospital fall rate group were identified using logistic regression. Findings: A sample of 1,529 hospitals (mean fall rate of 3.65 per 1,000 patient days) contributed data to the analysis. Latent class growth modeling findings classified hospital into three groups based on fall rate trajectories: consistently high (mean fall rate of 4.96 per 1,000 patient days), consistently medium (mean fall rate of 3.63 per 1,000 patient days), and consistently low (mean fall rate of 2.50 per 1,000 patient days). Hospitals with higher total nurse staffing (odds ratio [OR] = 0.92, 95% confidence interval [CI] [0.85, 0.99]), Magnet status (OR = 0.49, 95% CI [0.35, 0.70]), and bed size greater than 300 beds (OR = 0.70,95% CI [0.51, 0.94]) were significantly less likely to be categorized in the "consistently high" fall rate group.

    Journal Title

    Health Care Management Review

    Volume

    39

    Issue/Number

    4

    Publication Date

    1-1-2014

    Document Type

    Article

    Language

    English

    First Page

    352

    Last Page

    360

    WOS Identifier

    WOS:000341965900009

    ISSN

    0361-6274

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