Despite widespread efforts to reduce in-hospital patient falls, a new analysis in the Journal of the American Academy of Orthopaedic Surgeons (JAAOS) suggests that hospitals' fall prevention strategies may do little to curb injuries.

Approximately 3% to 20% of hospital patients fall at least once during their hospital stay, according to a JAAOS news release. CMS deems many of these falls preventable, meaning hospitals must absorb their associated costs. About 20% of fall-related injuries require medical attention, and treatments for such injuries cost the United States up to $20.2 billion each year, the release notes.

However, the literature review—which was conducted by researchers from The University of Texas Medical School at Houston—found that hospitals may not be able to control patient risk factors to prevent most falls. For example, one study included in the review showed that fall prevention programs, including patient education, vision assessments, and walking aids, did not reduce the fall rate among hospital inpatients. Meanwhile, another study in the review identified a strong correlation between falling and delirium, which underscores the need for hospitals to identify and manage the condition early.

"Of course, hospitals should educate patients and families, use bed rails, keep beds low, keep floors dry and clear of clutter—all common sense things that can reduce the risk of falls," one of the study's co-authors says. However, he notes that the study "found no proof that falls in hospital are…preventable," adding that falls therefore "shouldn't be categorized as a preventable occurrence and the burden shouldn't be borne by hospitals" (Clyburn/Heydemann, JAAOS, July 2011 [subscription required]; JAAOS release, 7/6).