Preventing Falls in Hospitalized Patients

Fall-prevention interventions that incorporate health IT were shown to reduce the risk for falls in hospitalized patients, according to findings from a study published in the Journal of the American Medical Association.

Falls have been known to cause injury and even death in patients of all ages, with the risk increasingly markedly with age. And although hospitalization further amplifies the risk, no evidence exists to support short-stay, hospital-based fall prevention strategies to reduce the incidence. In this study, researchers from Massachusetts General Hospital, Harvard Medical School, and Brigham and Women’s Hospital—all based in Boston, MA—set out to investigate whether a fall prevention tool kit (FPTK) using health information technology (HIT) would decrease patient falls in hospitals.

Patricia C. Dykes, RN, and colleagues conduced a randomized study from January 1, 2009, through June 30, 2009, comparing patient fall rates in four urban US hospitals in units that received usual care (5,104 patients) or the intervention (5,160 patients). According to the study, the tool kit integrated existing communication and workflow patterns into the HIT application.

Based on a valid fall risk assessment scale completed by a nurse, the FPTK software tailored fall prevention interventions to address patients' specific determinants of fall risk. The tool kit produced bed posters composed of brief text with an accompanying icon, patient education handouts, and plans of care, all communicating patient-specific alerts to key stakeholders, the investigators wrote. The primary outcome measured was patient falls per 1,000 patient-days, with fall-related injuries the secondary outcome.

During the 6-month intervention period, the number of patients with falls was higher in the control units (87 falls) compared with the intervention units (67). Fall rates fell from 4.18 falls per 1,000 patient days in control units to 3.15 in intervention units, and rates were particularly lower for patients age 65 and older, according to Dykes and colleagues, who found no significant difference between the two groups in fall-related injuries.

They concluded that “the use of a fall prevention tool kit in hospital units compared with usual care significantly reduced rate of falls.”

For more information:

• Fall Prevention in Acute Care Hospitals
• The Safe Discharge Plan
• Program May Help Prevent Falls in Hospitalized Patients

Do you think enough is being done to prevent falls in patients, particularly the elderly? Can IT play a significant role in helping to prevent falls?