Posted: May 13th, 2022

Potential Causes of Falls in Hospitals

Potential Causes of Falls in Hospitals
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Falls are a common and serious problem in hospitals, affecting both patients and staff. According to the World Health Organization (WHO), falls are the second leading cause of unintentional injury deaths worldwide, and each year an estimated 684,000 individuals die from falls globally, of which over 80% are in low- and middle-income countries (WHO 2021). In addition, approximately 37.3 million falls severe enough to require medical attention occur each year, resulting in significant disability, morbidity and health care costs (WHO 2021).

In this blog post, we will explore some of the potential causes of falls in hospitals, and discuss some of the strategies that can be implemented to prevent them.

Risk Factors for Falls in Hospitals
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Falls in hospitals are not inevitable or random events; they are often the result of a complex interaction of multiple risk factors that can be classified into intrinsic (related to the individual) and extrinsic (related to the environment or situation) categories. Some of the most consistently identified risk factors for falls in hospitalized patients are:

– Age: Older patients (>85 years) have a higher risk of falling due to physiological changes, comorbidities, cognitive impairment, sensory deficits and reduced mobility (Morris and O’Riordan 2017).
– Sex: Male patients have a higher risk of falling than female patients, possibly due to differences in behavior, activity level, muscle strength and bone density (Morris and O’Riordan 2017).
– Previous fall history: Patients who have fallen recently are more likely to fall again, as they may have underlying conditions, injuries or fear that increase their vulnerability (Morris and O’Riordan 2017).
– Gait and balance problems: Patients who have difficulty walking, standing or transferring due to weakness, pain, medication side effects or neurological disorders are more prone to falling (Morris and O’Riordan 2017).
– Agitation and confusion: Patients who are restless, agitated, confused or delirious due to dementia, delirium, infection or medication may wander, get out of bed unsafely or misjudge their abilities (Morris and O’Riordan 2017).
– Urinary incontinence or frequency: Patients who have urinary problems may need to use the bathroom frequently or urgently, especially at night, which may increase their risk of falling (Morris and O’Riordan 2017).
– Medications: Certain medications, such as sedatives, hypnotics, antipsychotics, antidepressants thesis topics, opioids and antihypertensives, can cause drowsiness, dizziness, orthostatic hypotension or impaired cognition, which can affect the patient’s balance and coordination (Morris and O’Riordan 2017).
– Neurocardiovascular instability: Patients who have conditions such as orthostatic hypotension, syncope, cardiac arrhythmias or stroke may experience sudden changes in blood pressure or heart rate that can cause fainting or loss of consciousness (Morris and O’Riordan 2017).

In addition to these intrinsic factors, there are also extrinsic factors that can contribute to falls in hospitals, such as:

– Hospital environment: The hospital setting can pose many hazards for patients who are unfamiliar with it, such as slippery floors, cluttered corridors, poor lighting, unfamiliar equipment or furniture (Van Wey et al. 2022).
– Medical devices: The use of IV lines, catheters, oxygen tubes or other medical devices can entangle patients or restrict their movement, making them more likely to trip or fall (Van Wey et al. 2022).
– Lack of supervision: Patients who are left alone or unattended may attempt to get out of bed or walk without assistance or proper equipment,
which can increase their risk of falling (Van Wey et al. 2022).
– Inappropriate footwear: Patients who wear ill-fitting shoes or slippers that are too loose or slippery may have difficulty walking or maintaining their balance (Van Wey et al. 2022).

Prevention Strategies for Falls in Hospitals
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Falls in hospitals can have serious consequences for patients’ health and quality of life, as well as for staff morale and satisfaction. Therefore,
it is important to implement effective prevention strategies that can reduce the incidence and severity of falls. Some of the evidence-based strategies that can be used are:

– Multifactorial assessment and intervention: This involves identifying patients at high risk of falling using a comprehensive assessment tool that covers both intrinsic and extrinsic factors,
and providing individualized interventions that address each factor, such as medication review, exercise, education, environmental modification, assistive devices and fall alarms (Morris and O’Riordan 2017).
– Multidisciplinary team approach: This involves engaging a team of health professionals from different disciplines, such as nurses, doctors, physiotherapists, occupational therapists, pharmacists and social workers, who can collaborate and communicate effectively to provide coordinated and holistic care for patients at risk of falling (Morris and O’Riordan 2017).
– Staff education and training: This involves providing staff with regular and updated information and skills on how to identify, assess and manage patients at risk of falling, as well as how to report and learn from fall incidents (Morris and O’Riordan 2017).
– Patient and family involvement: This involves educating and empowering patients and their families or caregivers on how to prevent falls, such as by following safety instructions, using appropriate footwear, asking for help when needed and reporting any concerns or changes in condition (Morris and O’Riordan 2017).
– Organizational leadership and culture: This involves creating a supportive and accountable organizational culture that prioritizes patient safety, encourages staff participation and feedback, provides adequate resources and equipment, monitors performance and outcomes, and implements continuous quality improvement initiatives (Morris and O’Riordan 2017).

Conclusion
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Falls in hospitals are a serious problem that can cause harm to patients and staff. However, they are not inevitable or random events; they are often the result of a complex interaction of multiple risk factors that can be identified and modified. By implementing evidence-based prevention strategies that involve a multifactorial assessment and intervention, a multidisciplinary team approach, staff education and training, patient and family involvement, and organizational leadership and culture, we can reduce the incidence and severity of falls in hospitals, and improve patient safety and quality of care.

References
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Morris R. O’Riordan S. 2017. Prevention of falls in hospital. Clinical Medicine 17(4):360–364.

Van Wey K. Metzler J. Williams J. 2022. Top five reasons why hospital falls occur. Van Wey Law Blog. https://www.vanweylaw.com/insights/top-reasons-hospital-falls-occur-medical-facilities/ (accessed October 10, 2022).

WHO. 2021. Falls. World Health Organization Fact Sheet. https://www.who.int/news-room/fact-sheets/detail/falls (accessed October 10, 2022).

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