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Review finds current fall prevention strategies may not be effective
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 Terry A. Clyburn |
A literature review published in the Journal of the American Academy of Orthopaedic Surgeons has reported many of the risks that frequently cause falls are not adequately addressed with fall prevention initiatives used in health care facilities.
Approximately 3% to 20% of inpatients fall at least once during their stay, according to an American Academy of Orthopaedic Surgeons press release, and because these falls are considered preventable by the Centers for Medicare and Medicaid the health care facilities they occur in are held accountable for any resulting injuries. However, the authors of the review found hospitals may not be able to prevent most falls – as many risk factors are not under the caregivers’ direct control.
“Our review of the literature revealed that the risk of fall is only slightly greater in the hospital environment than in the home and that there is no medical evidence that evidence-based guidelines are effective in fall prevention,” review authors Terry A. Clyburn, MD, and John A. Heydemann, MD, wrote.
One of the studies examined in the review found comprehensive fall prevention programs — including patient education, vision assessments and walking aids — did not reduce the incidents of falls for patients undergoing a typical inpatient hospital stay. It noted that such strategies are more effective in long-term care or carefully managed home care settings.
The review noted fall reduction methods currently used by health care settings are not harmful and do not increase risks, so they may be continued. Many patients who suffer falls in the hospital have internal risk factors or other conditions or disabilities that increase likelihood of falling. Evidence suggests there is no conclusive difference in the number of falls during typical, shorter length hospital stays at institutions with or without multifaceted fall prevention programs.
“Of course hospitals should educate patients and families, use bedrails, keep beds low, keep floors dry and clear of clutter — all the common sense things that can reduce the risk of falls,” Clyburn stated in the release. “But we found no proof that falls in hospital are, in fact, preventable. And if not, they should not be categorized as a preventable occurrence and the burden shouldn’t be borne by hospitals.”
Reference:
- Clyburn TA, Heydenmann JA. Fall prevention in the elderly: Analysis and comprehensive review of methods used in the hospital and in the home. J Am Acad Orthop Surg. 2011;19(7):402-409.
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