Understanding the causes and consequences of an injurious fall event is the first step to adopting a successful fall prevention program.

What is a fall?

For the purposes of our work, we define a fall as a sudden, unintentional descent, with or without injury to the patient, that results in the patient coming to rest on the floor, on or against some other surface, on another person, or on an object.

Source: National Database of Nursing Quality Indicators® (NDNQI®).

Why do people fall?

Both intrinsic and extrinsic fall risk factors contribute to fall risk. Extrinsic factors comprise conditions related to the environment, such as flooring conditions, workability of wheel chair locks, lighting, etc. Intrinsic risks generally comprise factors that characterize an individual and will be present regardless of what clothing or shoes the person wears and whether the person is living independently at home or is treated at the hospital. Such intrinsic factors “travel” with the individual and may include: age, gender, health status, medication effects, etc.

How serious is it?

Patient falls are one of the most reported incidents in hospitals, affecting from two to ten percent of hospital admissions. A fall can occur at any time, in any care setting. Fall prevention should be part of a culture of safety that helps protect and manage care throughout the care continuum.

Who is at greater risk?

Despite the statistics related to the elderly population, early studies reported the median age of a patient who falls in the hospital is 58-62. Thus, patient falls clearly are not a problem exclusive to the elderly. In one study, approximately half of patients who fell were younger than 65. The research showed that age is not an independent risk factor for falls. It is other risk factors that can be paired with age that signal risk of falling, such as impaired gait and mobility. Nonetheless, we recognize that a large number of falls occur among the elderly. Fall risks often develop within this population as part of a larger picture of emerging health challenges. To accurately identify which elderly patients are more prone to fall, we must use weighted evidence-based risk factors, rather than assuming age alone is a predictor of fall risk.