Interventions to reduce falls in hospitals: a systematic review and meta-analysis

2022/04/14 by Meg E. Morris, Meg E Morris, Kate E. Webster +18 · 267 citations
Health Professions · Medicine · Nursing · #Balance, Gait, and Falls Prevention #Emergency medicine #Fall prevention #Falls in older adults #Frailty in Older Adults #Injury prevention #Intensive Care Unit Cognitive Disorders #Intervention (counseling) #Logistic regression #MEDLINE #Medicine #Meta-analysis #Nursing #Odds #Odds ratio #Physical therapy #Poison control #Psychological intervention #Randomized controlled trial #Rehabilitation #Surgery #Systematic review

paper · pdf · doi:10.1093/ageing/afac077

published in Age and Ageing 51(5) (Oxford University Press)

openalex publication_date 2022/04/14 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/05

Abstract

BACKGROUND: Falls remain a common and debilitating problem in hospitals worldwide. The aim of this study was to investigate the effects of falls prevention interventions on falls rates and the risk of falling in hospital. DESIGN: Systematic review and meta-analysis. PARTICIPANTS: Hospitalised adults. INTERVENTION: Prevention methods included staff and patient education, environmental modifications, assistive devices, policies and systems, rehabilitation, medication management and management of cognitive impairment. We evaluated single and multi-factorial approaches. OUTCOME MEASURES: Falls rate ratios (rate ratio: RaR) and falls risk, as defined by the odds of being a faller in the intervention compared to control group (odds ratio: OR). RESULTS: There were 43 studies that satisfied the systematic review criteria and 23 were included in meta-analyses. There was marked heterogeneity in intervention methods and study designs. The only intervention that yielded a significant result in the meta-analysis was education, with a reduction in falls rates (RaR = 0.70 [0.51-0.96], P = 0.03) and the odds of falling (OR = 0.62 [0.47-0.83], P = 0.001). The patient and staff education studies in the meta-analysis were of high quality on the GRADE tool. Individual trials in the systematic review showed evidence for clinician education, some multi-factorial interventions, select rehabilitation therapies, and systems, with low to moderate risk of bias. CONCLUSION: Patient and staff education can reduce hospital falls. Multi-factorial interventions had a tendency towards producing a positive impact. Chair alarms, bed alarms, wearable sensors and use of scored risk assessment tools were not associated with significant fall reductions.

Cited by

• World guidelines for falls prevention and management for older adults: a global initiative
• Fall prevention through a systems approach: SEIPS, AcciMap and HTA findings from patient safety specialists
• Patient safety is our business! Staff perspectives on implementing hospital falls prevention education
• Choosing Wisely in Hospital Fall Prevention
• The experiences of older adults with cognitive impairment in using falls prevention alarms in hospital: A qualitative descriptive study
• Healthcare professional perspectives on barriers and enablers to falls prevention education: A qualitative study. [europepmc]
• Adult Inpatients' Perceptions of Their Fall Risk: A Scoping Review. [europepmc]
• Implementation of Virtual Communities of Practice in Healthcare to Improve Capability and Capacity: A 10-Year Scoping Review. [europepmc]
• Implementing Patient Falls Education in Hospitals: A Mixed-Methods Trial. [europepmc]
• World guidelines for falls prevention and management for older adults: a global initiative. [europepmc]
• Person-centered care approach to prevention and management of falls among adults and aged in a Brazilian hospital: a best practice implementation project. [europepmc]
• Prevalence and characteristics of registered falls in a Belgian University Psychiatric Hospital. [europepmc]
• How to tackle the global challenge of falls? [europepmc]
• Exploring Hospital Inpatients' Awareness of Their Falls Risk: A Qualitative Exploratory Study. [europepmc]
• Creating an Implementation Enhancement Plan for a Digital Patient Fall Prevention Platform Using the CFIR-ERIC Approach: A Qualitative Study. [europepmc]
• Falls risk perception measures in hospital: a COSMIN systematic review. [europepmc]
• Fall risk in older adults hospitalized with tumours: Contributing factors and prediction model. [europepmc]
• A stepped-wedge randomised controlled trial to assess efficacy and cost-effectiveness of a care-bundle to prevent falls in older hospitalised patients. [europepmc]
• Decoding the neurotoxic effects of propofol: insights into the RARα-Snhg1-Bdnf regulatory cascade. [europepmc]
• Inpatients' experiences of falls: A qualitative meta-synthesis. [europepmc]
• Staff perspectives on fall prevention activities in long-term care facilities for older residents: "Brief but often" staff education is key. [europepmc]
• Implementing falls prevention patient education in hospitals - older people's views on barriers and enablers. [europepmc]
• Mental health, fall prevention behaviors, and home environments related to fall experiences among older adults from ethnic groups in rural Northern Thailand. [europepmc]
• Enhancing Patient Safety Through an Integrated Internet of Things Patient Care System: Large Quasi-Experimental Study on Fall Prevention. [europepmc]
• Investigating the biomechanics of falls in older adults in long-term care using a video camera: a scoping review. [europepmc]
• Inpatient Falls: Epidemiology, Risk Assessment, and Prevention Measures. A Narrative Review. [europepmc]
• Features of effective hospital fall prevention trials: an intervention component analysis. [europepmc]
• Implementation strategies of fall prevention interventions in hospitals: a systematic review. [europepmc]
• Relationship Between Mobility and Falls in the Hospital Setting. [europepmc]
• A systematic review of multicomponent vs. single-component training programs for fall prevention in older adults. [europepmc]

Related

• Developing a multi-systemic fall prevention model, incorporating the physical environment, the care process and technology: a systematic review
• Patient education to prevent falls in subacute care
• Patient safety is our business! Staff perspectives on implementing hospital falls prevention education
• Fall prevention through a systems approach: SEIPS, AcciMap and HTA findings from patient safety specialists
• Falls in older people: epidemiology, risk factors and strategies for prevention