Fall-Prevention Programs and Interventions
May 1, 2004 | Evaluations & Guidance
Patient falls are a common cause of morbidity, nonfatal injuries, and trauma-related hospitalizations in the United States. Falls frequently result in serious damage requiring medical attention—for example, fracture (hip fracture is common), joint dislocation, or severe head injury. Further, fatalities from falls are not uncommon. Falls can also lead to a fear of falling again and to an increased dependence on the help of others, which itself can be debilitating. And any complication from a fall can contribute to an increased risk of future falls.
Falls are usually caused by a combination of factors rather than any one factor alone. Some factors are intrinsic to the patient, while others are extrinsic—that is, environmental. Intrinsic factors include physical and physiologic aspects (e.g., how steady the patient is on his or her feet) and the patient's cognitive and psychological condition. Extrinsic factors include furniture (bed height, for instance), lighting, floor surfaces, and even unfamiliar rooms. Facilities should attempt to minimize the effects of these factors to mitigate risks. In addition, they should provide a supportive environment that includes assistive measures such as handrails and nonslip bathing surfaces.
In the past, additional staff, such as in-room sitters, may have been given the responsibility of monitoring the patient as a fall-prevention intervention. While sitters may still be required for certain patients, facilities have turned to more cost-effective solutions and encouraging the use of other interventions, ranging from physical protections and restraints to special alert mechanisms. (Learn how to maximize the effectiveness of bed-exit alarms. ...