A Hospital System Approach at Decreasing Falls With Injuries and Cost

Sylvain Trepanier, DNP, RN, CENP; Julie Hilsenbeck, DNS, RN


Nurs Econ. 2014;32(3):135-141. 

In This Article


Falls and fall-related injuries continue to challenge health care organizations around the world to provide safer environments. Falls remain a primary health concern for older adults (Resnick & Junlapeeya, 2004). Risk factors for falling include age-related changes such as sensory alterations, muscle weakness, gait and balance disturbances, use of four or more prescription medications, alteration in activities of daily living, depression, and history of falling. As the population continues to age, the risk factors are almost inescapable. The time for serious inquiry into fall prevention and mitigation strategies is now.

International research demonstrates falls in inpatient acute care settings continue to be a safety threat. Research, however, fails to demonstrate how hospital fall prevention programs actually reduce fall rates (Koh, Hafizah, Lee, Loo, & Muthu, 2009; Lee, Chang, & Mackenzie, 2002; Semin-Goossens, van der Helm, & Bossuyt, 2003). In their groundbreaking report, Agostini, Baker, and Bogardus (2001) collected and described existing evidence on current patient safety practices. Since falls and falls with injury are a serious threat to our patients, and create a cost burden for hospitals, there is a need to identify the quality and financial impact of a standardized fall prevention program for adult patients in the acute care setting. The results of a quality improvement study aimed at identifying the effectiveness of a multifactorial fall prevention program in the acute care setting for adult patients is reported in this article.