Fall-prevention strategies based on individual patient needs may be better at reducing falls in acute-care settings

Avanecean D, Calliste D, Contreras, et al. Effectiveness of patient-centered interventions on falls in the acute care setting compared to usual care: A systematic review JBI Database of Systematic Reviews and Implementation Reports. 2017;15(12):3006-3048.

Review question

•        Compared to standard fall-prevention strategies, does making a specific strategy based on patient needs reduce falls in acute-care settings?

Background

•        Unintentional falls in acute settings (e.g., hospitals) may result in serious physical or psychological injuries unrelated to a patient’s illness.

•        Currently, standard strategies such as assessing fall risk and educating patients are used to manage fall risk, however these strategies do not account for differences in individual patient needs and risks.

•        Developing patient-specific fall-prevention strategies, which assess an individual patient’s risks and needs, is a promising solution to reduce falls in acute settings.

How the review was done

•        A detailed search of a number of electronic databases for studies published up to and including May 2016 was conducted.  Studies that focused on falls amongst patients aged 18 years and older with any illness in acute settings, were included in the review.

•        A total of 8,894 studies were identified in searches, and five were included in the review after assessments for eligibility.

•        The authors did not acknowledge any funding sources for this review.

What the researchers found

•        The review found some studies showed that using patient-specific fall-prevention strategies were effective in reducing falls, however more research is needed to confirm these results. 

•        Patient-specific fall-prevention strategies did not reduce the rate of injury from falls when compared to standard strategies.

•        While fall-prevention strategies that were specific to an individual patient’s risks and that used a number of approaches in combination were listed as ideal, no specific combination of approaches was described.

Conclusion

• This review found that patient-specific fall-prevention strategies may reduce falls, but are not effective in reducing injuries compared to usual approaches. More evidence is needed to definitively confirm whether tailored strategies are effective at reducing falls and preventing injuries.