New Tools Help Health Providers Reduce Patients' Risk of Falls
By Carolyn M. Clancy, M.D.
February 5, 2013
adults, falls are serious, whether they take place in the home or in a health
one-third of adults over age 65 fall each year. Falls can cause bone fractures,
disability, and even death. Among people 75 and older, falls are far more
likely to cause admissions into a long-term care facility than for adults 10
years younger, Federal data show.
An estimated 500,000 falls happen each year in
U.S. hospitals, causing 150,000 injuries. Patients have a higher risk of falls
- Have weak muscles or problems walking.
- Take drugs or a combination of drugs that
make them sleepy.
- Use a cane or walker.
- Have chronic conditions.
- Need to use the bathroom frequently.
providers have known for a long time that falls among patients are a serious
problem. But they haven't always agreed on the best way to prevent them.
changing, which means you or your loved ones may be safer from falls in the
hospitals and long-term care settings use new programs based on scientific
evidence of what works best. The goal is to make sure clinicians understand the
risk of falls, identify which patients have the higher risk, and take steps to reduce
A new toolkit from the Agency for Healthcare Research and Quality (AHRQ) focuses on the challenges that hospitals face as they try to develop and sustain a fall-prevention program. In addition to helping hospitals gain support for this process, the toolkit describes the steps that organizations can take to put the best fall-prevention strategies into practice.
Another program is
an AHRQ-funded project (PDF File, Plugin Software Help) from a Wisconsin health system, a health
technology company, and a university-based school of nursing. They developed a computerized
program with four individual care plans, based on patients' risk for a fall and
their ability to follow instructions on how to prevent one.
helps nurses develop fall-prevention plans that match patients' needs and that can
go in patients' electronic health records.
the program identifies patients who are usually at low risk for falls but who may
have an injury or condition that increases their risk.
patients, steps to reduce falls include—
- Making sure they are carefully
watched the first time they get out of bed after surgery or a procedure.
- Making sure they or a family member
understand the need to call and wait for help before doing something that could
cause a fall.
- Helping them identify hazards or
behaviors that make a fall more likely.
- Learning safer approaches before they
leave the hospital.
are at a high risk of falling but can follow steps on how to prevent a fall.
For these patients,
steps to reduce falls include—
- Making sure they understand why they
should use a walker or other device to help them move safely.
- Consulting with the pharmacist or
physician to be careful about drugs that can increase the risk of falls.
- Using an alert system, such as wristbands,
signs, or other communication to warn of the risk of falls.
We know that
communication and teamwork among health care providers are important to reduce
errors and improve patient safety. In fact, up to 70 percent of medical errors,
including falls, are due to breakdowns in communication among health care
this need, AHRQ and the Department of Defense have developed a teamwork system specifically for
long-term care settings. Known as
TeamSTEPPS®, the system is based on more than 20 years of research into how
teamwork improves safety. It is used in hundreds of hospitals across the United
results show that TeamSTEPPS improves safety and quality in long-term care
settings. For example, staff using teamwork skills reduced the rate of serious
pressure ulcers among nursing home residents by 48 percent.
risk of falls in hospitals and long-term care settings is an important goal.
New tools can help health providers—and their patients—attain it.
Carolyn Clancy, and that's my advice on how to navigate the health care system.
Agency for Healthcare Research and Quality
Preventing Falls in Hospitals: A Toolkit for Improving Quality of Care (Overview)
Computerized Fall Risk Assessment Process to Tailor Interventions in Acute Care
http://www.ahrq.gov/downloads/pub/advances2/vol1/Advances-Hook_25.pdf [Plugin Software Help]
Long-Term Care Version
for Disease Control and Prevention
Older Adults: An Overview
Patient Safety Foundation
about Patient Safety
Current as of February 2013
New Tools Help Health Providers Reduce Patients' Risk of Falls. Navigating the Health Care System: Advice Columns from Dr. Carolyn Clancy, February 5, 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/consumer/cc/cc020513.htm