A fall is defined as an event where a person unintentionally ends up on the floor, ground, or another lower surface, and it is among the most commonly recorded adverse events in healthcare institutions.

Objective of the Initiative

The aim of this initiative is to reduce falls and their consequences through targeted measures that healthcare professionals can apply.

Causes of Falls

Falls in healthcare facilities often occur within the first days of hospitalization and result from multiple and often interrelated internal (patient-related) and external (environmental and behavioral) factors. The most common risk factors include:

• Previous falls, Delirium, Balance disorders, Reduced muscle strength, Gait disturbances, Orthostatic hypotension, Malnutrition, Urinary incontinence, Visual impairment, Polypharmacy

• Environmental hazards, Lack of use of assistive devices

• Ageing: Falls are more common among older adults, and the risk increases with age.

One-third of people aged 65 and older who live at home experience a fall each year, and more than half of those living in nursing homes fall annually. Patients over 64 years old, as well as those aged 50-64 with underlying medical conditions, are at particular risk.

Consequences of Falls

Falls can have serious consequences for patients and result in significant healthcare costs. Consequences may include fractures, pain, functional decline, and an increased need for assistance.

Hip Fractures

Hip fractures are among the most severe consequences of falls. A recent study at Landspítali revealed a one-year mortality rate of 21% for women and 36% for men following a hip fracture, with mortality increasing with age.

Another Icelandic study on patients who underwent hip fracture surgery at Landspítali found that survivors experienced significant loss of independence, with fewer able to return home and more requiring nursing home care.

Psychological Impact

Falls can have significant psychological effects, including:

• anxiety

• depression

• fear of falling again

Falls may trigger a chain reaction of events that are difficult to stop. Frightened individuals become less independent, change their lifestyle, and move less due to fear of falling.

This fear can lead to reduced strength, flexibility, and endurance, increasing the risk of additional falls.