From the Research
To decrease the risk of falls in elderly patients in the hospital, a multifactorial approach including patient education, physical therapy, medication reviews, and environmental modifications is recommended, while non-slip socks and bed alarms may offer some benefit but are not sufficient alone, and soft wrist restraints are discouraged due to potential harm and violation of patient dignity. Several evidence-based interventions can effectively reduce fall risk in hospitalized elderly patients. Multifactorial approaches work best, including:
- Regular toileting schedules
- Proper lighting
- Keeping personal items within reach
- Maintaining clear pathways
- Patient and family education about fall risks and how to request assistance
- Physical therapy to improve strength and balance, along with appropriate assistive devices like walkers or canes
- Medication reviews to reduce or modify drugs causing dizziness, hypotension, or sedation
- Environmental modifications such as lowering beds, using floor mats, and installing handrails Non-slip socks may offer some traction but are not sufficient alone, and their use is supported by some studies, such as 1, which found a preventive effect in reducing the recurrence of falls. However, other studies, such as 2 and 3, have found inconclusive or negative results, highlighting the need for careful consideration of their use. Bed and chair alarms provide early warning of unauthorized movement but should not replace staff vigilance, as shown in 4, which found no significant difference in fall rates with their use. Soft restraints, on the other hand, are now discouraged as they can increase agitation, cause injuries, and violate patient dignity, and instead, one-to-one supervision for high-risk patients is preferred. These interventions work by addressing the multiple factors that contribute to falls, including physical limitations, environmental hazards, and medication effects, while preserving patient dignity and independence, as discussed in 5.