Older patients and falls in hospital

Abstract

Over a quarter of a million falls are reported by the UK hospitals each year, predominantly harming older patients whose vulnerability to falling arises from a complex interaction of risk factors, including impaired mobility, dementia, delirium, medication and the effects of long term and acute illness. Systematic review of research trials indicates that multifactorial assessment and intervention to treat, modify or better manage these underlying risk factors can reduce falls by 20–30%. However, the evidence base is not always reflected in hospitals’ falls prevention policies, and is not consistently delivered to patients. The organizational culture and processes that can increase the effective delivery of evidence-based falls prevention are discussed, alongside learning from quality improvement projects. Systematic learning from reported falls and essential care after an inpatient fall are also explored.