Measuring Falls Events in Acute Hospitals-A Comparison of Three Reporting Methods to Identify Missing Data in the Hospital Reporting System

摘要

OBJECTIVES: To compare three different methods of fallsudreporting and examine the characteristics of the data missing from the hospital incident reporting system.udDESIGN: Fourteen-month prospective observational studyudnested within a randomized controlled trial.udSETTING: Rehabilitation, stroke, medical, surgical, andudorthopedic wards in Perth and Brisbane, Australia.udPARTICIPANTS: Fallers (n5153) who were part of audlarger trial (1,206 participants, mean age 75.1 � 11.0).udMEASUREMENTS: Three falls events reporting measures:udparticipants’ self-report of fall events, fall events reported in participants’ case notes, and falls events reported through the hospital reporting systems.udRESULTS: The three reporting systems identified 245 fallsudevents in total. Participants’ case notes captured 226ud(92.2%) falls events, hospital incident reporting systemsudcaptured 185 (75.5%) falls events, and participant selfreport captured 147 (60.2%) falls events. Falls events were significantly less likely to be recorded in hospital reporting systems when a participant sustained a subsequent fall, (P5.01) or when the fall occurred in the morning shiftud(P5.01) or afternoon shift (P5.01).udCONCLUSION: Falls data missing from hospital incidentudreport systems are not missing completely at random andudtherefore will introduce bias in some analyses if the factor investigated is related to whether the data ismissing.Multimodal approaches to collecting falls data are preferable to relying on a single source alone.