A Neuro-Pathophysiological and Digital Synthesis of Nursing-Led Fall Prevention - A Systematic Literature Review

Inpatient falls represent an exceptionally complex, multi-dimensional safety challenge that transcends simple clinical error, positioning nursing staff at the critical, high-stakes intersection of real-time clinical vigilance, neuro-pathophysiological synthesis, and macro-level systemic risk mitigation. This definitive review synthesizes high-impact evidence from the 2018–2025 period to evaluate the multifaceted, evolving role of the nurse in fall prevention, analyzing a fundamental paradigm shift from static, checklist-driven risk assessment to dynamic, systems-oriented prevention models supported by deep-learning analytics and pervasive surveillance technologies. Through a comprehensive systems-approach lens, the paper explores the quantifiable efficacy of multifactorial "safety bundles," the critical pharmacological oversight of Fall-Risk-Increasing Drugs (FRIDs), and the pervasive, often deleterious impact of organizational stressors such as nursing burnout, staffing volatility, and the "missed care" phenomenon. The methodology involved an exhaustive, multi-database systematic search of PubMed, Cochrane, and Google Scholar, identifying 17 seminal sources that demonstrate an inextricable and mathematically significant correlation between nursing workload and patient trauma incidence. Key findings suggest that while information technology provides unprecedented predictive precision, the professional clinical judgment and redundant safety layers provided by the nurse remain the only effective defense against the "Swiss Cheese" model of systemic failure. The review concludes that a sustainable, long-term reduction in fall-related injuries requires a proactive safety culture rooted in continuous professional education, structured post-fall debriefing, and an uncompromising institutional commitment to evidence-based staffing levels.