Reducing the risk of falls in hospitals – led by Apollo Hospital

Overview Overview Overview

Falling is the most common problem faced by older people. These drops can cause serious injury. According to a study published in the Indian Journal of Public Health * in 2019, falls (especially among the elderly) are the most frequently reported cases in long-term care hospitals, which account for 14-53% of India.

Several research studies on fall risk assessment document fall risk factors established in the hospital environment. However, evaluation alone cannot prevent a patient from falling. If you or your loved one is hospitalized, you should take general measures such as being in bed or sitting to reduce the risk of falling during hospitalization. Nurses and other caregivers can easily access what they need, such as food, water, and phones.

Apollo Hospital conducted an audit of nurses’ knowledge and practices regarding the prevention and management of patient falls.

Definition of autumn

A patient’s fall is defined as an event in which a patient suddenly falls (falls) to the floor unplanned, with or without injury.

Falling can be at different levels. That is, from one level to the ground level, for example, slipping, stumbling, stumbling, resulting in the same level of bed, wheelchair, stairs down, collision, pushing, pushing, another underground For people, that is, holes and other openings on the surface.

In emergency hospitals, not all patient falls are predictable or preventable. Some falls are the result of individual physiological responses to illness or treatment in a care environment where walking of the patient is essential for recovery.

Autumn type

  1. Accidental fall– Occurs when a patient falls unintentionally due to an environmental hazard or equipment failure (14% of all falls).
  2. Expected physiological fall– Occurs in patients with known risk factors for trips associated with the patient’s underlying medical condition (78% of all falls)
  3. Unexpected physiological fall– Falls that occur in patients for whom risk factors have not been identified until a fall occurs – fainting, seizures, etc. (8% of all falls)

Fall risk assessment

IPSG6 (International Patient Safety Goal 6), which is part of the evidence-based fall safety initiative, was developed to prevent patient falls. Fall prevention programs should focus primarily on patient characteristics and activities associated with an increased risk of falls. Although there is some form of assessment of a patient’s fall risk that may help determine when special preventive interventions are needed, there is currently little evidence to support the use of fall risk assessment tools.

There is nothing to suggest that the use of common evaluation tools (identified in the literature) provides higher accuracy than tools developed by the institution based on the characteristics of patients in the area.

Currently, there are no interventions that have proven effective in preventing falls in acute care environments. However, expert opinion suggests that institutions should have a fall prevention program consisting of multiple interventions aimed at minimizing the risk of falls for individual patients. The use of multiple fall prevention interventions has been the most common approach, but the results of their effectiveness are inconsistent.

How hospitals prevent patients from falling

Our benchmark is 0.5 rate per 1000 inpatients.Apollo Hospital is taking more steps to reduce falls

The countermeasures are as follows.

  1. Identifying vulnerable groups
  2. Evaluation of vulnerable patients within 2 hours.
  3. Apply the yellow band.
  4. Apply the side railing.
  5. Brake all cribs.
  6. Patient first card on the edge of the crib.
  7. Education for relatives on fall risk prevention.
  8. Education of fall risk assessment staff.
  9. Use of grab bars and call bells.
  10. The importance of using safety belts on stretchers and wheelchairs.
  11. Conduct training on a regular basis.

High risk assessment with modified Morse fall risk scale and subsequent precautionary measures

What the patient should and should not do to prevent / mitigate the risk of falls

If you are a patient, the nurse will tell you about the risk of falling while you are in the hospital. Based on your risk, a personalized fall prevention plan will be created to keep you safe. A daily travel plan keeps the patient moving. The following are general recommendations and prohibitions made for your safety.

what I have to do

  1. Always sit for a while before standing up and walking to prevent dizziness and falls.
  2. Keep the washroom floor dry
  3. Shower mats at home can be used to prevent the bathroom from falling for those who have difficulty walking on wet or tiled floors
  4. Ask for help, especially when you need to go to the washroom at night and early in the morning
  5. You can ask your doctor if any of the prescribed medications can cause examples of dizziness, antihypertensives, painkillers like tramadol, and take the necessary precautions to avoid falls.
  6. Regular exercise
  7. Wear non-slip shoes
  8. Make sure the entrance and stairs area is bright enough
  9. Education for patients and relatives regarding fall risk prevention.

Do not

  1. Do not put the side rails down
  2. Don’t forget to ask for help
  3. Do not darken the room
  4. Do not move around or walk (walk around) without the help of a healthcare professional
  5. Be sure to inform the nurse during the change of attendant
  6. For attendants / caregivers / nurses
  7. Do not leave the patient
  8. Keep only patients out of the washroom, especially at night
Reduce the risk of falls


A patient’s fall can cause lacerations, fractures, or internal bleeding, leading to increased medical use. Research shows that nearly one-third of falls can be prevented. Fall prevention involves managing the patient’s underlying fall risk factors and optimizing the physical design and environment of the hospital. Therefore, knowing the education module, night supervisor rounds, fall campaigns in hospitals, hospital-wide posters on fall prevention, and fall risk will help organizations overcome the challenges associated with maintaining a fall prevention program. ..

Author’s contribution:
Quality system department
Hyderabad Apollo Health City

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