Translating fall incidence data into fall-preventive measures in geriatric wards--a survey in Belgian hospitals

Fall incidents and their negative outcomes represent a considerable problem in hospitals, especially in geriatric wards, and require implementation of strategies to prevent these undesirable events. For this reason, the College of Geriatrics, a body funded by the Belgian Government to set up quality improvement initiatives in geriatric wards, selected 'Fall prevention in Belgian hospitals' as a quality project for the year 2006.

Before developing and implementing a practice guideline specifically adapted to the clinical context in Belgian geriatric wards, this study was set up to gain insight into fall prevention measures currently implemented in geriatric wards of Belgian hospitals.

In this study, we used a cross-sectional survey design. The study involved 113 hospitals with a geriatric department. Participants were geriatricians, head nurses, medical directors, care coordinators and occupational therapists. Measurements were carried out using a survey questionnaire (response rate: 56.6%).

Less than one third (32.8%) of Belgian geriatric wards had a formal fall prevention policy. However, more than 90.0% systematically registered falls, but less than a quarter used these data to improve preventive measures. Although the majority used screening (78.1%), comprehensive assessment (92.2%), and preventive strategies (98.4%) when patients are admitted, only about 10% used a standard plan to direct these efforts. Furthermore, 93.8% acknowledged using physical restraints as a fall prevention strategy.

Given the high rates and complexity of falls in geriatric wards, hospitals need to further implement evidence-based assessment and standard intervention care plans to maintain uniformity and quality of care.