Fall Prevention in Acute Care Hospitals

Meta‐analysis: Multidisciplinary fall prevention strategies in the acute care inpatient population

“…Once such data were excluded, the above inclusion and exclusion criteria identified 6 primary articles for review. 9,[21][22][23][24][25] Additionally, a cluster randomized fall prevention trial in a mixed inpatient population was published by Cumming et al 26 in 2008. The study was excluded, as the participants were pooled between rehabilitation wards and acute inpatient wards, and only incomplete data were reported separately for the acute inpatient wards.…”

“…All but 1 study had a large sample size, with 1000-patient days ranging from 11.1 to 160.3. 9,[21][22][23][24] Components of the Intervention Multidisciplinary interventions were complex, and formulated based on available evidence for individual interventions and modifiable fall risk factors (Table 3). Each study reviewed included a fall risk assessment to risk-stratify participants and modulate intervention according to risk.…”

“…Each study reviewed included a fall risk assessment to risk-stratify participants and modulate intervention according to risk. 9,[21][22][23][24][25] Each study implemented fall prevention programs in a slightly different way. Krauss et al 23 used nurses to complete a Morse Fall Scale and subsequently implement several standard interventions based on risk.…”

“…Brandis 21 employed a team of nurses and the aid of the Director of Occupational Therapy to assess risk (using an undisclosed system) and carry out an intervention. Dykes et al 22 examined an electronic fall prevention tool kit (FPTK) using the electronic medical record (EMR). This intervention began with the Morse Fall Score, which triggered automatically ordered interventions that did not require personal oversight.…”

Ten ways to improve the care of elderly patients in the hospital

“…25 Some aspects of these multifactorial interventions include environmental modifications such as low beds, high-impact floor mats, restraint removal, bedside posters and patient education materials, and exercise. 13,26 Medication review and reductions in medications that contribute to falls (psychoactive medications, diuretics, blood pressure agents) can also reduce fall risk. 13,14 Many experts recommend checking a 25-hydroxy vitamin D level for patients who come into the hospital for treatment of a fall-related injury, starting or continuing vitamin D and calcium supplementation for those with normal vitamin D levels, and starting aggressive vitamin D replacement with 50,000 units of oral ergocalciferol weekly for those with a level below 20 ng/ mL.…”