Submit Manuscript | http://medcraveonline.com Abbreviations: NDNQI, the national database of nursing quality indicators; CDC, center for disease control; US, united states of America; IOM, the institute of medicine; AHRQ, agency for health research quality Epidemiology of falls Among adults (65years and over), falls are the leading cause of injuries that cause pain, emotional distress and loss of independence, reduced quality of life, increased number of hospitalization days, morbidity and mortality. 1 It is estimated that by 2025, this group of patients will constitute approximately 1.2billion of the world population, eighty percent of whom will live in developed countries. 2 The rate of falls among adult’s increases with age, with the prospect of falls in people aged 65 and older at about 35%, increasing to about 42% for those over 75years of age. Fifteen percent (15%) of patients, who fall, have a history of falling twice or more a year. Falls are the second cause of death in the US (75% of them are elderly people) with the death rate in the United States reaching36.8 per 100,000 people. 3 Fall rates in hospitals range from about 30% to 50% or a range of 3.3 to 11.5 falls per 1,000 hospitalization days, 4 and they are the most frequently reported adverse events. Fall-related morbidity and mortality rates in hospitals are signifcant. It is estimated that at least 3-20% of the falls have resulted in injury. 5 About 30% of the hospitalized patients who fall suffer injuries due to the fall, of which 4-6% suffer from severe injuries, including fractures, brain hemorrhage, bleeding and mortality risks. 6 Fall-related injury rate during hospitalization accounts for up to 533 per 1,000 person-years for all injuries, 20 per 1,000 person-years for hip fractures, 270 per 1,000 person-years for head injuries. 7 A ‘fall’ is defned as “an unplanned descent to the foor with or without injury to the patient”. 8 The National Database of Nursing Quality Indicators (NDNQI) is the largest national database of US data relating to quality of nursing care. 9 Falls in hospitals is one of the quality indices measured by the NDNQI organization since 2003 as a proportion of all falls per 1,000 hospitalization days. The reported fall rates range from 1.3 to 8.9 falls/ 1,000 hospitalization days. 10,11 The lowest rates of falls are reported in Intensive Care Units (1.3 per 1,000 hospitalization days), adult wards (3.92 per 1,000 hospitalization days), and the highest rates are reported in rehabilitation wards (7.3 per hospitalization 1,000 days). 12 The main risk factors for falls in hospitalized patients are impaired gait, confusion, urinary incontinence, history of falls and psychotherapeutic medications. 13 Economical costs The economic burden of falls in general hospitals is signifcant. Indeed, it was found that falls increased the cost of hospitalization per patients that have fallen to an average of $6,669, and if the injury was caused due to a fall, the extra cost is on average between $12,000 to $23,000. 14 In 2013, the gross expenditure from falls in the U.S was Nurse Care Open Acces J. 2017;2(3):93‒96 93 © 2017 Toren et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Falls prevention in hospitals-the need for a new approach an integrative article Volume 2 Issue 3 - 2017 Orly Toren, Michal Lipschuetz Hadassah medical Organization, Israel Correspondence: Michal Lipschuetz, Hadassah medical Organization, Israel, Email michal.lipschuetz@gmail.com Received: February 20, 2017 | Published: March 08, 2017 Abstract Currently, around the world, hospitals invest a considerable amount of effort into preventing patients’ falls during hospitalization. Despite the intensive emphasis targeted in preventive intervention, reducing the prevalence of this phenomenon has been limited. At present, hospitals focus on measuring risk of fall rates based on specific and rigid risk assessment scales which are mainly focused on the assessment of the patient’s medical condition, mobility, mental status, toileting, history of falls and medication therapy. Fall prevention programs are based on the above mentioned key factors, which focus on standard safety procedures associated with both patient’s condition and hospital environment. The purpose of this article is to describe the current developments on this topic and to suggest an additional direction of thinking strategy that includes three parts: i. Engaging the patient into the assessment process to evaluate his/her medical condition and his/her perception of personal fall risk. ii. Creating a customized/personalized fall prevention program for patients susceptible to falls. iii. Evaluate the patient’s intentions and ability to engage in the required behavior to prevent falls based on the Prevention program. This new approach of incorporating all of the three elements may be the basis for decision-makers on a national and local level to formulate a new hospital policy and procedures to deal with patients’ falls, on the basis of a comprehensive understanding of this long-standing concern. Keywords: patients fall prevention, behavioral intentions, patient participation, risk fall assessment Nursing & Care Open Access Journal Mini Review Open Access