Inpatient falls in adult acute care settings: influence of patients' mental status.

AIM This paper is a report of a study of fallers' mental status as one of the patient-related intrinsic risk factors for falls. BACKGROUND Whether confusion is one of the most important risk factors associated with risk of falling in hospital settings is unclear. Literature reviews have not identified consistent evidence for effective preventive interventions for patients with mental status deficits. METHODS This retrospective research was conducted in six adult acute care units in a community hospital in the United States of America. The data source was the 1017 fall incidents occurring between 1 July 2005 and 30 April 2009. Descriptive statistics and Pearson chi-square tests were used to analyse the data. RESULTS The presence of mental status deficits was identified as the dominant issue in 346 (34%) falls. The group of fallers with mental status deficits (32.1%, n = 111) seemed to have fewer toileting-related falls than those without mental status deficits (46.7%, n = 314). Fallers with mental status deficits tended to have more severe fall injuries than those without mental status deficits (chi(2) = 10.08, d.f. = 3, P = 0.018). CONCLUSION Risk assessment and targeted surveillance should be used as part of falls prevention policy. Involving nursing staff and family members in assessing a patient's mental status may help to prevent falls caused by mental status deficits.