Senior Managing Partner
Patient falls in hospitals have been recognized as a major patient safety issue for many years.
In 2005, the Joint Commission on Accreditation of Healthcare Organizations added reducing the risk of patient falls to its list of National Patient Safety Goals.
In 2013, the Agency for Healthcare Research and Quality published a fall prevention toolkit as a resource for hospitals to use for patient fall prevention.
The Joint Commission issued a Sentinel Alert regarding prevention of falls and fall-related injuries in hospitals in 2015.
Studies report that 30 to 50% of patient falls in hospitals result in injury, including about 10% resulting in serious injury, such as fractures, brain injuries, and death. Older patients are more likely to fall and to have more severe injuries from a fall.
Prevention of Patient Falls
Fall prevention starts with an assessment of a patient’s fall risk, followed by use of fall prevention strategies appropriate for the patient’s fall risk score.
Several fall risk assessment tools are widely used in hospitals, including the Morse, Hendrich, and KINDER fall risk assessments. Risk factors typically identified in fall assessment tools include age, history of a recent fall, impaired mobility, weakness, urinary incontinence or frequency, certain medical conditions, medications that can affect mental status, postural hypotension (lowered blood pressure when standing from a seated position), and altered mental status/impaired cognition.
After a fall risk assessment has been made, measures must be taken to ensure that all hospital staff who are involved in caring for the patient are aware of the patient’s fall risk. This can include fall alert signs on the patient’s door or bed, colored wrist bands, and notes/fall risk alerts in the electronic medical record.
Fall prevention measures must be based on the patient’s individual condition. Fall prevention measures include one- or two-person assistance (depending on the patient’s needs) with standing and walking, putting beds in the lowest position, nonskid footwear, putting bed rails up, and the use of gait belts to help stabilize patients when standing and walking and to provide a means for hospital personnel to control a patient’s descent to the ground if they fall, to lessen any resulting injury.
Fall prevention programs have been shown to be effective in reducing falls and fall-related injuries.
Hospital Policies and Procedures for Fall Risk Assessment and Fall Prevention
Hospitals are required to have policies and procedures for assessment of patient fall risk and fall prevention.
A typical hospital fall prevention policy requires assessment of a patient’s fall risk using a standardized, evidence-based fall assessment tool, followed by implementation of appropriate fall prevention measures depending on the patient’s fall risk score.
A number of simple measures can be implemented to reduce the risk of patient falls, such as having gait belts and bed-exit alarms placed in readily available locations.
Hospital staff must be trained regularly on fall prevention measures to ensure effectiveness of fall prevention policies in practice.
The attorneys at Stritmatter Law are experienced in handling cases involving patient falls at hospitals and nursing homes and available for consultation if you or a family member has been injured as a result of a fall at a hospital.