Why Do Patients in Acute Care Hospitals Fall?

A study to determine why patients in acute care hospitals fall learned that inadequate information and nurses’ lack of familiarity with patients facilitated falls, while accurate information and signage, teamwork with colleagues, and the involvement of patients or families helped prevent falls.

Falls are a persistent problem in hospitals. The authors conducted four focus groups each with nurses and assistants on patient fall risk and prevention, and used content analysis to interpret the data.

The nurses and assistants discussed six concepts in their focus groups: (1) patient report; (2) information access; (3) signage; (4) environment (5) teamwork; and (6) involving the patient or family. Patient report and information allowed nurses and assistants to have current information about the patients and their needs, while signage provided visual cues to fall risk. Environment included the availability of equipment and having a clutter-free room, and teamwork included working together with and covering for colleagues. The six concepts led the authors to develop two key categories–knowledge/communication and capability/actions–that facilitate or prevent falls.

The authors concluded that a patient care plan, including current fall risk status and appropriate interventions, needs to be available to the patient, the patient's health care team and family, and that they all must use that information to carry out the interventions.