• Linda M Hoke and Rachel T Zekany.
• Linda M. Hoke is a clinical nurse specialist, cardiac intermediate care unit, Hospital of the University of Pennsylvania, Philadelphia.
• Crit Care Nurse. 2020 Dec 1; 40 (6): 33-41.

BackgroundDespite vast evidence describing risk factors associated with falls and fall prevention strategies, falls continue to present challenges in acute care settings.ObjectiveTo describe and categorize patient and nurse perspectives on falls and nurses' suggestions for preventing falls.MethodsTo improve transparency about the causes of falls, nurses interviewed patients in a 48-bed progressive cardiac care unit who had experienced a fall. A content analysis approach was used to examine responses to 3 open-ended items: why patients said they fell, why nurses said the patients fell, and nurses' reflections on how each fall could have been prevented.ResultsOver a 2-year period, 67 falls occurred. Main themes regarding causes of falls were activity (41 falls, 61%), coordination (16 falls, 24%), and environment (10 falls, 15%). Patients said they fell because they slipped, had a medical issue, were dizzy, or had weak legs. Nurses said patients fell because they had a medical issue or did not call for assistance.ConclusionsNurses and patients agreed on the causes of assisted falls but disagreed on the causes of unassisted falls. Nurses frequently said that the use of a bed alarm could have prevented the fall.©2020 American Association of Critical-Care Nurses.

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