• Teresa A Williams, Gail King, Anne-Marie Hill, Maha Rajagopal, Tina Barnes, Anita Basu, Graeme Pascoe, Katherine Birkett, and Heather Kidd.
• Centre for Nursing Evidence Based Nursing, Education & Research, Royal Perth Hospital, Perth, WA, Australia. williams@cyllene.uwa.edu.au
• J Clin Nurs. 2007 Feb 1;16(2):316-24.

Aims And ObjectivesTo evaluate a systematic, coordinated approach to limit the severity and minimize the number of falls in an acute care hospital.BackgroundPatient falls are a significant cause of preventable injury and death, particularly in older patients. Best practice principles mandate that hospitals identify those patients at risk of falling and implement interventions to prevent or minimize them.MethodsA before and after design was used for the study. All patients admitted to three medical wards and a geriatric evaluation management unit were enrolled over a six-month period. Patients' risk of falling was assessed using a falls risk assessment tool and appropriate interventions implemented using a falls care plan. Data related to the number and severity of falls were obtained from the Australian Incident Monitoring System database used at the study site.ResultsIn this study, 1357 patient admissions were included. According to their risk category, 37% of patients (n = 496) were grouped as low risk (score = 1-10), 58% (n = 774) medium risk (score = 11-20) and 5% (n = 63) high risk (score = 21-33) for falls. The incidence of falls (per average occupied bed day) was eight per 1000 bed days for the study period. Compared with the same months in 2002/2003, there was a significant reduction in falls from 0.95 to 0.80 (95% CI for the difference -0.14 to -0.16, P < 0.001).ConclusionWe evaluated a systematic, coordinated approach to falls management that included a falls risk assessment tool and falls care plan in the acute care setting. Although a significant reduction in falls was found in this study, it could not be attributed to any specific interventions.Relevance To Clinical PracticePreventing falls where possible is essential. Assessment of risk and use of appropriate interventions can reduce the incidence of falls.

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