Abstract
One-hundred seventy-seven randomly selected hospitalized adult patients were assessed for their risk of falls by 24 registered nurses (RNs). Twelve specific indices of fall risk assessment were studied. Patients' scores on three separate fall risk-assessment scales also were calculated. Only one of the fall risk-assessment scale scores was significantly associated with documented implementation of the hospital fall prevention protocol. A follow-up study of most of these patients' medical records by seven RNs resulted in seven patients being found to have had at least one documented inpatient fall. These findings demonstrate the importance of: (1) further identifying and defining indices of fall risk assessment, (2) investing staff energy and resources in a comprehensive program of education and fall prevention, and (3) identifying intervention strategies that can be documented to prevent inpatient falls.
The United States Department of Health and Human Services included fall prevention in its publication, Healthy People 2000 (1990). The National Health Promotion and Disease Prevention objectives included in this publication call for a reduction in deaths from falls and fall-related injuries by the year 2000.
In acute care hospitals, inpatient falls are consistently the largest single category of reported incidents (Gaebler, 1993; Rawsky, 1998). Falls are recognized as a leading cause of injury and death, particularly among the elderly (Spellbring, 1992). Of all fall-related deaths in the United States, 70% occur among the elderly (Commodore, 1995). Half of those over the age of 75 who fracture a hip as the result of a fall die within 1 year of the incident (Hendrich, 1988).
Interdisciplinary health research initiatives designed to develop and evaluate effective clinical strategies to reduce the occurrence of inpatient falls and their sequelae are, therefore, a necessary, integral component of continuous quality improvement in any acute care setting.
Moreover, research-based practice is a genuine organizational value and should infuse all staff development activities regarding fall risk assessment and fall prevention (Brown, 1999; Morse, 1997).