Falls resulting in injury are a prevalent patient safety problem. Elderly and frail patients with fall risk factors are not the only ones who are vulnerable to falling in health care facilities. Any patient of any age or physical ability can be at risk for a fall due to physiological changes of a medical condition, medications, surgery, procedures, or diagnostic testing that can leave them weakened or confused. In health care facilities, falls with serious injury are consistently among the Top 10 sentinel events reported to The Joint Commission’s Sentinel Event database.

Hospitals and nursing home facilities are required to provide adequate supervision to prevent accident and falls. Upon admission to any facility, nursing is required to do an assessment on the patient/resident’s fall risk and provide prevention strategies with the goal of avoiding a fall.

Analysis of falls with injury reveals the most common contributing factors pertain to:

  • Inadequate assessment
  • Communication failures
  • Lack of adherence to protocols and safety practices
  • Inadequate staff orientation, supervision, staffing levels or skill mix
  • Deficiencies in the physical environment
  • Lack of leadership

In case assessment, records are reviewed for standards of care required by nursing to identify any breaches seen. Fall risk assessments and planning by nursing are also considered in having met standard of care responsibilities. 

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