Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr;19(2):86-93.
doi: 10.1111/wvn.12571. Epub 2022 Mar 9.

Fall prevention in hospitals and nursing homes: Clinical practice guideline

Daniela Schoberer  1 , Helga Elisabeth Breimaier  2 , Julia Zuschnegg  1 , Thomas Findling  3 , Susanna Schaffer  4   5 , Tamara Archan  6
Affiliations

Fall prevention in hospitals and nursing homes: Clinical practice guideline

Daniela Schoberer et al. Worldviews Evid Based Nurs. 2022 Apr.

Abstract

Background: Falls and their consequences are particularly common in older adults in hospitals and long-term care (LTC) facilities.

Aim: To avoid falls and their consequences, and provide nurses with an overview of all relevant research literature on fall prevention, and a practice guideline on fall prevention in older adults was developed.

Methods: The development process included a systematic literature review to identify systematic reviews and primary studies on the topic of fall prevention, an assessment of the study quality, the preparation of meta-analyses to summarize the results, and the application of the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to grade the scientific literature. The guideline panel and an external multidisciplinary team graded the recommendations using the Delphi method. In addition, the panel and team formulated expert opinions.

Results: A total of 79 randomized controlled trials on fall prevention were identified, which formed the basis of the recommendations. Strongly recommended measures for both settings included multifactorial interventions, professionally supported body exercise interventions, and education and counselling interventions. The panel and team did not recommend the use of a specific assessment tool for fall risk assessment, low-floor beds in hospitals, or body exercise interventions in frail residents.

Linking evidence to action: During the development of this guideline, particular attention was paid to collecting evidence-based knowledge relevant to practice. By applying the recommendations, the outlined nursing care is justified, enabling healthcare personnel to achieve the overriding goal of providing optimal care to persons at risk of falling. Evidence for several fall prevention interventions was graded as very low. Sound intervention studies are necessary to strengthen the confidence in the evidence for low-floor beds, alarm sensor systems, medication review, and staff education in hospitals.

Keywords: GRADE approach; falls; guideline; hospital; long-term care; nursing home.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Guideline development process
See this image and copyright information in PMC

References

    1. Anderson, O. , Boshier, P.R. & Hanna, G.B. (2012) Interventions designed to prevent healthcare bed‐related injuries in patients. Cochrane Database of Systematic Reviews, 1, CD008931. 10.1002/14651858.CD008931.pub3 - DOI - PMC - PubMed
    1. Andrews, J. , Guyatt, G. , Oxman, A.D. , Alderson, P. , Dahm, P. , Falck‐Ytter, Y. et al. (2013) GRADE guidelines: 14. Going from evidence to recommendations: The significance and presentation of recommendations. Journal of Clinical Epidemiology, 66(7), 719–725. 10.1016/j.jclinepi.2012.03.013 - DOI - PubMed
    1. Balshem, H. , Helfand, M. , Schünemann, H.J. , Oxman, A.D. , Kunz, R. , Brozek, J. et al. (2011) GRADE guidelines: 3. Rating the quality of evidence. Journal of Clinical Epidemiology, 64(4), 401–406. 10.1016/j.jclinepi.2010.07.015 - DOI - PubMed
    1. Basic, D. & Hartwell, T.J. (2015) Falls in hospital and new placement in a nursing home among older people hospitalized with acute illness. Clinical Interventions in Aging, 10, 1637–1643. 10.2147/cia.S90296 - DOI - PMC - PubMed
    1. Breimaier, H.E. , Halfens, R.J. & Lohrmann, C. (2015) Effectiveness of multifaceted and tailored strategies to implement a fall‐prevention guideline into acute care nursing practice: a before‐and‐after, mixed‐method study using a participatory action research approach. BMC Nursing, 14, 18. 10.1186/s12912-015-0064-z - DOI - PMC - PubMed

Publication types