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Keywords:

  • Falls;
  • incident report;
  • pattern;
  • underreporting

Purpose

To examine the pattern of underreporting of fall incidents in a general psychiatric hospital in Japan.

Design and Methods

All fall incidents were analyzed and stratified by ward.

Findings

A discrepancy in fall rates was found in acute psychiatric and dementia wards. The following indicators were suggestive of underreporting: “zero fall/1,000 patient-days,” “proportion of falls without injury,” and “proportion of falls identified as occurring in the bedroom as a fall location during certain time periods.”

Practice Implications

Ward-specific fall rates, with further stratifications by time and location of the fall, were useful for identifying a pattern of underreporting.