Fall Prevention in Acute Care Hospitals

A Randomized Trial

Falls and fall-related injuries harm patients in hospitals, increasing lengths of stays and hospital costs. A single fall—and subsequent fear of falling—can start a downward spiral of reduced mobility for a person.

To create a fall-risk assessment and personalized intervention to reduce falls, researchers first identified barriers and facilitators to interventions. They then developed a prototype toolkit based on six risk factors: a recent fall, medical diagnosis, needing help walking, receiving intravenous therapy, gait characteristics and impaired mental status. An illustrator created icons to standardize and simplify communications of bedside alerts that then became the basis for a bed poster, patient education handouts and a plan of care.

The research team tested the fall prevention toolkit (FPTK) in four Boston-area hospitals and compared fall rates in units that received the intervention (5,160 patients) with units that received usual care (5,104 patients).

The results:

  • There were fewer patients with falls in the four intervention units (67) than the four control units (87).
  • The fall rate per 1,000 patient-days was 3.15 in the intervention units compared with 4.18 in control units.
  • Patients older than 65 years of age benefited more from the intervention than younger patients.

More work is needed to identify interventions that can reduce injuries and trauma from falls.