The Risk Factors Associated with Patient Falls

Patient falls are one of the most frequent and costly hospital acquired conditions in the United States. Beyond the fall itself, hospitals are concerned about adverse events and injuries caused by a patient falling out of bed. These risks and injuries can include bruising, fractures, dislocations, brain injuries, a decline in overall health, and in some instances, death.¹

Patient falls can be one of the most challenging hospital incidents for healthcare providers to approach because of the varying risk factors and circumstances that contribute to each fall.

Who is at Risk for a Fall?

The National Center for Patient Safety has identified a number of physiological and internal risk factors that contribute to a patient’s risk of hospital falls including:²

1. Age
2. Chronic Disease
3. Visual Impairment
4. A Previous Fall
5.  Medication
6. 
   

Age

Older patients are 9 times more likely to experience a fall during a hospital visit than patients under the age of 65.³ In acute care facilities, it is said that 1 in 5 elderly patients will fall during their stay. This risk factor has serious implications as the baby boomer cohort continues to age, which will cause a spike in the elderly population. The likeliness for falls is due to a combination of factors associated with aging, including chronic disease, mental awareness, and use of medication. These combinations can affect a patient’s cognitive perception and strength, resulting in falls from bed, or while walking, or during toileting.

Visual Impairment

Cataracts, myopia, and other visual impairments can increase the likelihood of patient falls. Altered vision can distort the patient’s perception of the hospital bed, including proximity and height, creating a greater fall risk for patients. In fact, patients facing visual impairment are 250% more likely to experience a fall.⁴

Chronic Disease

Patients suffering from a chronic disease such as arthritis or postural hypotension (low blood pressure) face a higher risk of falling. Patients with arthritis are considered 2.4 times more likely to experience a hospital fall, while hypotension is said to be associated with 20% of all elderly patient falls.⁴ Chronic disease can contribute to muscle weakness, lightheadedness, or difficulty of movement for patients, which reduces the ability to safely exit a hospital bed, posing a greater risk of falls.

A Previous Fall

A previous fall is one of the best determinants of fall risk. Fall history patients are 3 times more likely to experience another fall.⁴ A fall history may indicate decreased mobility in elderly patients, due to complications such as hip fractures, which is also a factor in the  increased the risk of falls. Nurses should be aware that previous fall risk indicators may still be present in patient cases.

Medication

There are 3 classes of medication that can significantly increase fall risk. They are sedatives and hypnotics (sleeping aids), antidepressants, and benzodiazepines (tranquilizers). Combinations of 4 or more medications, which are common in the treatment of older patients, are said to increase the likelihood of a patient fall. ⁵ The increased use of medication may cause dizziness and disorientation, causing increased risk of patient falls. Medication can also impair mobility by causing muscle stiffness or weakness, further increasing patient fall risk.

Solutions

Patient falls continue to be a high priority for healthcare officials due to the frequency and varying factors associated with each fall.

The use of a low hospital bed has been recommended as an integral part of a hospital’s fall prevention strategy by a number of healthcare organizations, including The Joint Commission, the FDA, the VA, and CMS. CHG Hospital Beds’ Spirit Select low bed is the safe choice when it comes to patient safety and fall prevention.

The Spirit Select low hospital bed is designed to keep patients safe with its low height of 10” from the floor. A standard hospital bed ranges from 18”-20” from the floor, and can have serious implications for patient falls. Paired with CHG’s Deluxe Fall Floor Pad, Spirit Select can reduce the impact of a fall and minimize patient injury by reducing fall height. The low height of the Spirit Select allows patients to adjust the bed to accommodate their needs and can reduce falls when exiting the bed.

For more information, visit www.chgbeds.com to see how the Spirit Select can be used as a valuable component to your hospital’s fall prevention strategy.

This blog post is the first entry in a series of patient fall prevention posts by CHG Hospital Beds.

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CHG Hospital Beds specializes in low hospital beds that are designed to prevent patient falls and related injuries within acute care environments. We are focused on patient and nurse safety and deliver innovative solutions to meet the needs of our customers.

Sources:

¹Premier, Inc. (2012). The Centers for Medicare and Medicaid (CMS). Premier, Inc. Retrieved from https://www.premierinc.com/safety/topics/guidelines/cms-guidelines-4-infection.jsp

²United States Department of Veterans Affairs. (2012). VHA NCPS Fall Prevention and Management. National Center for Patient Safety. Retrieved from: http://www.patientsafety.gov/CogAids/FallPrevention/index.html#page=page-5

³OHPE. (2008). Preventing Falls Among Seniors. OHPE. Retrieved from http://www.ohpe.ca/node/9659

⁴Public Health Agency of Canada. (2009). Risk Factors for Falls and Fall-Related Injuries in Seniors. Public Health Agency of Canada. Retrieved from http://www.phac-aspc.gc.ca/seniors-aines/publications/pro/injury-blessure/falls-chutes/chap3-eng.php

⁵Harding, A. (2009). Psychotropic drugs boost fall risk in the elderly. Reuters Health. Retrieved from http://www.reuters.com/article/2009/11/23/us-psychotropic-drugs-idUSTRE5AM4LH20091123