In Australia, there are more hospital admissions for fall-related injuries than for transport related injuries1. Every person admitted to hospital has risk factors for having a fall while in hospital.
According to the World Health Organization, a fall is defined as "an event which results in a person coming to rest inadvertently on the ground or floor or other lower level"2. This includes slips, trips, loss of balance and applies to events that are witnessed as well as unwitnessed.
Falls contribute to increased length of stay, risk of functional decline and may trigger residential aged care admission.
Reducing the risk of falls while the person is in hospital will also help to reduce the risk of falls after they are discharged. Falls are one of the most common adverse events associated with hospital care and the consequences can include injury and even death.
Falls can be described as:
Accidental: resulting from environmental factors, such as clutter, tubing or spills that cause a patient to slip or trip.
Anticipated physiological: stemming from known intrinsic factors (such as postural hypotension, dementia and gait or balance deficits) or extrinsic factors (for instance, certain medications or improper ambulatory aids).
Unanticipated physiological: caused by unexpected or unknown medical episodes (such as sudden myocardial infarction, stroke, syncope, or seizure). These falls can’t always be prevented, which is one reason why organisations can’t expect to achieve a zero fall rate.
Intentional: when patients intentionally fall to the floor; these are rare in general hospital settings3.
Regardless of falls classification or category, falls result from the interaction between the individual and their physiological risk factors, behaviour and the environment.
1. Tovell, A., et al., Hospital separations due to injury and poisoning, Australia 2009-10, in Injury research and statistics 2012: AIHW, Canberra.
2. World Health Organization, Fact Sheet 344: Falls 2012, World Health Organization.
3. Quigley, P., et al., Reducing serious injury from falls in two veterans' hospital medical-surgical units. Journal of nursing care quality, 2009. 24(1): p. 33-41.