Exploring Characteristics of Falls in Outpatient Clinics Affiliated with US Acute Care Facilities

Problem/purpose: There is extensive research on factors associated with patient falls in the inpatient setting. Little is known, however, about patient falls in outpatient clinics. This study’s purpose was to examine patient falls in outpatient clinics by select event characteristics and affiliated hospital demographics.

Data analysis: This is a descriptive study using data from 2018 data from a national nursing quality database. The sample consisted of 1704 outpatient clinics affiliated with 266 US acute care hospitals which submitted both patient falls and patient visit data for at least nine months. Annualized patient falls per 1,000 patient visits were calculated for each outpatient clinic. Descriptive statistics were calculated on fall injury level, whether the fall was assisted by an employee, whether the fall was the result of physiological event, and patient age. ANOVA modeling was used to determine statistical significance for the affiliated hospital characteristics of bed size, teaching status, and ANCC Magnet designation.

Results: The mean unit ambulatory care fall rate was 0.10 falls per 1,000 patient visits, and the median was zero. The majority of falls resulted in no injury (75%) and were not assisted by an employee (85%). Less than 40% of falls were the result of a physiological event. The mean age of patients who fell was 54 years old and approximately half of patients who fell were male (51%). No statistical difference was found based on affiliated hospital demographics of bed size < 300 and ≥ 300, teaching status, or ANCC Magnet designation.

Ambulatory care nursing implication: The rate of patient falls in ambulatory care settings is considerably lower than the rate in inpatient units. There is still room for improvement, however. One current opportunity for improvement in outpatient clinics is to implement precautions and provide additional assistance to patients known to be at risk for falls. Another is the identification and mitigation of environmental risk factors for falls. Additional research and more comprehensive patient risk assessment may also lead to more actionable data for reducing patient falls in outpatient clinics.