Nursing-Led Interventions for Preventing Falls in Hospitalized Patients: A Systematic Literature Review

Background: In-hospital falls are common adverse events associated with injuries, functional decline, prolonged length of stay, and increased healthcare costs, which require effective and sustained nursing interventions. Objective: To identify, through a Systematic Literature Review, which nursing care interventions are effective in reducing the incidence/rate of falls among inpatients in hospital settings. Methods: A systematic literature review was conducted using the JBI methodology. The review was guided by the PICO framework (P: inpatients; I: nursing care interventions; C: usual care; O: incidence of accidental falls). A comprehensive search was performed in the MEDLINE, CINAHL, and Scopus databases. Studies were included if they evaluated nursing-led or nursing-related interventions aimed at fall prevention and reported fall-related results. Eligible study designs included randomized controlled trials, quasi-experimental studies, observational studies, and quality improvement initiatives. Study selection, data extraction, and critical appraisal were conducted according to JBI recommendations. Results: Six studies were included (quasi-experimental, cohort, prospective/observational, and quality improvement projects). Two main themes emerged: (1) structured multifactorial and educational interventions and (2) technology-based interventions. Multifactorial approaches that combine risk assessment, education, communication, and environmental measures have been shown to improve adherence and reduce falls. Technology-based interventions, especially video monitoring, showed the most consistent reductions in fall rates, including fewer nighttime falls and decreased need for one-to-one observation. The included studies were methodologically heterogeneous in design, clinical setting, and outcome definitions, which precluded statistical pooling and warrants caution in the interpretation of the findings. Conclusions: Structured, standardized, multifactorial, and nursing-led approaches can contribute to reducing inpatient falls. However, more robust and comparable studies are required to consolidate practice-relevant recommendations.