Fall Prevention in Adult Patients Hospitalized in Acute Care Wards: A Narrative Literature Review Conducted Using a Systematic Approach

Abstract

Introduction. Falls in hospitals are frequent adverse events with significant clinical and organisational implications. Patients with neurological conditions are particularly at risk, as motor deficits, balance disorders and cognitive changes increase the likelihood of falling.

Study design. A narrative literature review was conducted using a systematic approach.

Materials and methods. A search was carried out in PubMed to identify studies published between 2020 and 2025, in Italian or English language, involving adult patients hospitalised in acute care wards. Original quantitative studies describing structured fall prevention interventions and reporting fall and/or fall-related injury rates, comparing the post-implementation period with the preceding period or with control wards, were included.

Results. Six studies were included. The interventions described included nurse education with systematic fall risk assessment, overnight video monitoring, electronic surveillance with or without a dedicated staff member, multicomponent programmes, analytical tools integrated into the electronic clinical records and wearable sensors connected to alert systems. In most studies structured programmes were associated with reduced fall rates and, in some cases, reduced rates of falls resulting in injury, particularly when technologies were embedded in organisational pathways with clearly defined roles and response times.

Discussion. In acute care wards, particularly those with a high proportion of patients with neurological conditions, multicomponent fall prevention programmes that are integrated into nursing workflows and supported by a clear organisation of the response to alerts are promising strategies. Further studies are needed to assess their long-term effectiveness and sustainability and their transferability to different settings.