Preventing falls and reducing injury from falls at a tertiary hospital in China: a best practice implementation project

Introduction: Falls are among the most frequently reported serious and preventable adverse events in hospitalized adults, often leading to significant injuries, including fractures, subdural hematomas, or even death. Objective: This project aimed to promote evidence-based fall prevention practices and reduce fall-related injuries among hospitalized adult patients at a tertiary hospital in China. Methods: Guided by the JBI Evidence Implementation Framework, this project was conducted across nine pilot wards at a tertiary hospital in China from July 2024 to April 2025. Eight audit criteria were developed to measure compliance with best practices related to fall risk screening and multifactorial assessment, individualized and patient-centered interventions, staff training, and patient education. Barriers were analyzed and addressed through targeted strategies. A follow-up audit evaluated changes in compliance, as well as improvements in nurses’ knowledge, attitudes, and practices. Falls and fall-related rates before and after the intervention were also assessed. Results: Compliance improved across all eight audit criteria. Nurses demonstrated improved knowledge and practice, while patients showed improved knowledge, attitudes, and practices regarding fall prevention. The falls rate declined from 0.48 to 0.25 per 1,000 patient days, while the incidence of fall-related injuries decreased from 35.3% to 0%. Conclusions: This best practice implementation project strengthened multifactorial falls risk assessment and personalized interventions, enhanced nurses’ and patients’ engagement in falls prevention, and ultimately reduced falls and fall-related injury rates among hospitalized patients. Spanish abstract: http://links.lww.com/IJEBH/A498