Patient falls in health care facilities are a leading cause of mortality, injury and disability. According to the Centers for Disease Control and Prevention, “In 2004, 14,900 people 65 and older died from injuries related to unintentional falls” (Hendrich, 2007). Despite years of efforts to reduce falls and fall-related injuries, acute care facilities have had limited success.
- Falls are a common occurrence in hospitals with rates between 2.2 and 17.1 falls per 1000 patient days depending on hospital type and patient populations (Galbraith, Memon, & Harty, 2011).
- Approximately 2% to 12% of all patients have at least one fall during their hospital stay (Falen, Unrub, & Segal, 2011).
- Falls also contribute to higher rates of mortality: patients who fall have up to a 50% higher mortality than patients who do not (Falen et al., 2011).
Understanding the psychiatric aspects of falls prevention is an important part of a falls reduction program in the acute care setting as many causal factors can be considered mental health symptoms.The falls rate in healthcare facilities is up to three times higher than the community. It is estimated that 78% of falls in hospitalized patients can be categorized as predictable physiological falls, i.e. occurring in individuals exposed to identifiable risk (Lovallo, Rolandi, Rossetti, & Lasignani, 2009). A focus on interventions that are synced with workflow and the use of SBAR communication may help prevent falls in the acute care setting. There is a long-standing need to shift from a crisis management to proactive approach in the prevention of falls risk and related injuries (Taylor, Parmelee, Brown, & Ouslander, 2005). New approaches to fall prevention must be developed and implemented to lower the rate of patient falls which has remained constant in recent years. An intervention-based approach to fall prevention education may lower the percentage of patients that sustain a physical injury from a fall. Psychiatric professionals can accomplish a fall risk assessment with every intake simply by increasing their awareness of the items included in a falls risk assessment. Reducing patient fall-related injuries is a National Patient Safety goal of The Joint Commission. Centers for Medicare and Medicaid have acknowledged that injuries from falls in health care facilities are an important quality issue. However, fall prevention programs for hospitalized patients have had limited success, and multifaceted strategies for implementing fall prevention programs are good start but cannot guarantee success (Tzeng, 2011).
Hendrich, A. (2007). Predicting Patient Falls Using the Hendrich II Fall Risk Model in clinical practice. American Journal of Nursing, 107, 50-58.
Galbraith, J. G., Memon, A. R., & Harty, J. A. (2011). Cost Analysis of a Falls-prevention Program in an Orthopaedic Setting. Clinical Orthopaedics and Related Research, 12, 3462-3468.
Falen, T., Unrub, L., & Segal, D. (2011). Electronic Fall Surveillance System Model. The Health Care Manager, 30, 342-351.
Taylor, J. A., Parmelee, P., Brown, H., & Ouslander, J. (2005). The Falls Management Program: A Quality Improvement Initiative for Nursing Facilities (#290-00-0011). Washington, DC: U.S. Government Printing Office.
Tzeng, H. (2011). Nurses’ Caring Attitude: Fall PreventionProgram Implementation as an Example of Its Importance. Nursing Forum, 46, 137-145.
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