Hospital Fall Prevention Strategies

Introduction to Fall Prevention

The American Geriatrics Society states that there are no adequate randomized controlled trials of multifactorial intervention studies to reduce falls among hospital inpatients, despite this being a widely implemented strategy 1

Review and reduce medications, particularly in patients taking ≥4 medications or any psychotropic drugs, as recommended by the American Geriatrics Society 1, 2, 3, 4
Psychotropic medications show a consistent association with falls across all settings, according to the American Geriatrics Society 1
Medication reduction was a prominent component of effective fall-reducing interventions in multifactorial studies, as noted by the American Geriatrics Society 1
No clear difference exists between long- and short-acting benzodiazepines for fall risk, as reported by the American Geriatrics Society 1
Comprehensive medical assessment with specific treatment of identified problems reduces falls, as recommended by the American Geriatrics Society and supported by evidence from the BMJ 1, 5, 6
Priority targets based on evidence include postural hypotension management, cardiovascular disorders, visual problems, balance, gait, and transfer deficits, as identified by the American Geriatrics Society and the BMJ 1, 5, 6
Older people with recurrent falls should receive long-term exercise and balance training, as recommended by the American Geriatrics Society 1
Target interventions to improve balance, transfers, gait, strength, and range of motion of lower extremities, as suggested by the BMJ 5, 6

Home environmental hazard modification alone shows equivocal or no benefit, as reported by the American Geriatrics Society 1, 2, 3, 4
Advice alone about fall risk factors without implementation measures is ineffective, according to the American Geriatrics Society 1, 2, 3, 4
Self-management programs were not beneficial, as noted by the American Geriatrics Society 1, 2

Sustained compliance with interventions is required for effectiveness, as emphasized by the American Geriatrics Society 1
Avoid relying solely on assistive devices without addressing other risk factors, as warned by the American Geriatrics Society 8
Do not implement staff education programs alone in acute hospital settings, as advised by the American Geriatrics Society 1

Immediate medication review for all at-risk patients, including reduction of total medications if ≥4 drugs and discontinuation or minimization of psychotropic medications, as recommended by the American Geriatrics Society 1, 2, 3, 4
Targeted medical assessment focusing on postural hypotension, cardiovascular disorders, and visual impairment, as suggested by the American Geriatrics Society and the BMJ 1, 5, 6
Physical therapy consultation for patients with balance deficits, gait abnormalities, and transfer difficulties, as recommended by the BMJ 5, 6
Environmental assessment at discharge with facilitated home modifications for high-risk patients, as recommended by the American Geriatrics Society 1