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Keywords:

  • elder care;
  • epidemiology;
  • falls;
  • hospital;
  • nurses;
  • nursing home

Aims and objectives.  The aim of the present study was to describe the first fall rates in hospitals and nursing homes throughout Germany. Relationships between age, gender, care dependency, medical disciplines, bed confinement and falls were investigated.

Background.  Little is known about fall rates in German hospitals and nursing homes.

Method.  Prevalence studies were conducted in the year 2002 and 2004. Forty hospitals and 15 nursing homes took part in 2002 (3923 patients and 1252 residents older than 65 years) and in 2004 there was a total of 39 hospitals and 29 nursing homes (4451 patients and 2374 residents older than 65 years). Staff nurses used a standardized instrument to collect data about falls in the last two weeks in their institutions and also about other patient problems. Descriptive and inferential statistics were used as well as logistic regression.

Results.  The first fall rate in 2002 (2004) in the hospitals was 4·7 (4·2) and in the nursing homes 4·5 (5·1) per 1000 patient/resident days. Most of the hospital patients fell on geriatric wards. The high care dependent patients fell more often than the low care dependent patients. In 2002, mobile nursing home residents were at a higher risk of falling than residents confined to bed, but those results could not be confirmed in 2004.

Conclusions.  Falls of patients over 65 years of age are as much of a problem in German hospitals as they are in German nursing homes.

Relevance to clinical practice.  Fall preventive methods should be implemented both in nursing homes and hospitals. Care dependency is a stable risk factor for falls in hospital patients.