Fall Prevention Efforts in Hospitals

Abstract

Falls are deadly and costly events in health care facilities and have become a primary focus of most hospital quality improvement programs. Falls can occur to patients with simple medical problems as well as those with more complex diagnosis and treatment. From the emergency room, intensive care unit, general inpatient floor to outpatient settings falls can turn a routine patient care encounter into a complicated matter with potential for significant mortality, cost, morale, quality, and public image repercussions. Falls can result in no or minimal harm with injuries ranging from scrapes, bumps, and bruises up to lengthened, expensive, and stressful patient stays for significant injuries or may even result in traumatic death. Falls among hospitalized patients occur frequently and some repeatedly. Of those who fall, 28% have bruises and minor injuries, 11.4% have severe soft tissue wounds, and 5% have fractures. An additional 2% have head trauma, which can lead to a subdural hematoma, long-term disability, or death [1]. Evidence supports the need for interventions aimed at reducing the risk of falls and decreasing the number and severity of falls events. The Collaborative Alliance for Nursing Outcomes and the National Data Base of Nursing Quality Indicators have identified falls as a primary nursing quality indicator. In 2005 The Joint Commission added requirements that both acute and long-term care facilities assess and periodically reassess patients for risk of falls. In 2006 the Centers for Medicare and Medicaid Services [2] identified falls as “never events”, which are defined as serious, preventable and costly medical errors with the potential for death. CMS proposed and promoted strategies to prevent and reduce falls to lower the incidence of “never events” [2].