The current integrative literature review of 23 studies aimed to identify multidimensional risk factors of falls among older adult patients in acute care hospitals. The incidence rate of fall-related injuries ranged from 6.8% to 72.1%. Advanced age was a major intrinsic risk factor, whereas being a patient in a geriatric unit was a significant extrinsic factor for inpatient falls and fall-related injuries based on statistical significance obtained from quantitative data analyses. Other critical risk factors were: (a) cognitive impairment; (b) impaired mobility; (c) prolonged length of hospital stay; and (d) fall history. Environmental/situational factors, such as patient ambulation and fall locations, also contributed to inpatient falls. In clinical practice, nurses need to know who are the most vulnerable patients in the hospital and develop comprehensive interventions to decrease intrinsic, extrinsic, and environmental risk factors. Prospective mixed-methods studies are needed to examine psychosocial factors and consequences of falls.

Falls and injurious falls are a major safety concern for patient care in acute care hospitals. Inpatient falls and injurious falls can cause extra financial burden to patients, families, and healthcare facilities. This article provides clinical implications and recommendations for adult inpatient fall and injurious fall prevention through a brief review of factors associated with falls and injurious falls and current fall prevention practices in acute care hospitals.