Patient unassisted fall in Ward 4C en-suite bathroom
Occurred: 2025-03-04T10:52 UTC · Reported: 2025-03-08T18:52 UTC
Clinical Narrative & Synthesized Abstract
Synthesized Abstract: At 10:52 UTC in Ward 4C, a minor safety event occurred involving bathroom fall. The incident was assigned preliminary risk score 18 in the Low band.
At 10:52, an 82-year-old post-operative patient in Ward 4C (Bed 3, Bay 2) mobilized unassisted to the en-suite bathroom despite high fall risk status. Patient slipped on wet vinyl floor adjacent to the shower basin and fell onto left side. Emergency pull-cord was activated. Attending nursing staff arrived within 30 seconds. Patient was conscious, alert, with GCS 15/15, and reported moderate pain in left hip without loss of consciousness or head strike. Plain film pelvis and hip radiography performed; no cortical breach. Anti-slip flooring CAPA completed.
Risk Evaluation & Score Breakdown
Deterministic multi-term risk score from 1 to 100 derived from clinical harm, recurrence, and reporting lag.
Top Similar Incidents in General Medicine
Semantic similarity calculated across category, location, and clinical narrative keywords.
Patient fall event (Bathroom fall) in Ward 4C
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Root Cause Analysis & Safeguards Workspace
Explore 5 Whys causal pathways, 6-bone fishbone decomposition, and barrier analysis safeguards.
Corrective & Preventive Actions (1)
Install anti-slip high-traction flooring strips and additional grab rails in Ward 4C patient en-suite bathrooms.
Parties Involved (4)
Masked by default per governance protocolHandover & Action Notes (2)
Immediate clinical examination conducted post-fall. Patient assisted to bed using slide sheet protocol. Primary survey: GCS 15/15, pupils equal and reactive, vital signs stable (BP 132/78, HR 74, SpO2 98%). Plain film radiography of left hip and pelvis requested. Paracetamol 1g administered.
Radiology results reviewed with duty radiologist—no acute fracture, dislocation, or bone cortex disruption identified. Post-fall mobility assessment completed. Floor hazard rectified by domestic team. Yellow fall-risk wristband and non-slip socks verified. Hourly comfort rounds logged.