Previous falls
A history of falling can indicate that closer assessment is required.
NurseNet Clinical Skills
Falls Risk Assessment and Prevention
Learn how to recognise common falls risks, assess the patient and environment, support safer mobility and use practical prevention measures to reduce avoidable harm.
Falls prevention starts with
01
Recognise risk
Look at the patient, history and environment.
02
Assess mobility
Understand how safely the patient can move.
03
Reduce hazards
Make the immediate environment safer.
04
Support mobility
Use appropriate assistance and equipment.
05
Review changes
Falls risk can change during admission.
Patient safety
Why falls prevention matters
Falls can cause pain, injury, loss of confidence and longer hospital stays. Risk may increase because of illness, medication, mobility problems, confusion, poor vision or hazards in the environment.
Falls prevention is not about stopping patients from moving. The goal is to support mobility and independence while reducing avoidable risk.
Student nurses are often well placed to notice small changes in a patient's condition, behaviour or mobility that may increase their likelihood of falling.
Falls risk is dynamic. A patient who was safe yesterday may need more
support today following illness, medication changes, surgery or deterioration.
Risk factors
What can increase the risk of a fall?
Falls usually result from several interacting factors rather than one single cause.
Mobility and balance
Weakness, unsteadiness or difficulty transferring can increase risk.
Cognition
Confusion, delirium or reduced safety awareness can affect mobility.
Medication
Some medicines may contribute to dizziness, sedation or postural hypotension.
Vision
Reduced vision may make obstacles and environmental changes harder to detect.
Continence needs
Urgency may lead patients to rush, particularly when help is not immediately available.
Footwear
Poorly fitting or inappropriate footwear can make walking less safe.
Environment
Clutter, poor lighting, wet floors and inaccessible call bells can increase risk.
Acute illness
Infection, dehydration, fatigue or deterioration can reduce strength and stability.
Assessment
A practical falls risk assessment approach
Follow the approved assessment process and local guidance in your placement organisation.
1
Know the patient
Review previous falls, mobility, cognition, medication and relevant clinical history.
2
Observe mobility
Notice how the patient transfers, stands and walks where this can be assessed safely.
3
Check the environment
Look for hazards around the bed, chair, bathroom and walking route.
4
Identify individual risks
Consider what specifically makes this patient vulnerable to a fall.
5
Put prevention measures in place
Follow the agreed care plan and provide the required assistance or equipment.
6
Review and document
Reassess when the patient's condition changes and document actions clearly.
Prevention
Practical ways to reduce falls risk
Call bell within reach
Make it easy for patients to request assistance before trying to move.
Support toileting
Plan assistance around continence needs and reduce the need for rushing.
Appropriate footwear
Encourage footwear that supports safer mobility where appropriate.
Reduce hazards
Keep walking routes clear and deal with spills or clutter promptly.
Mobility aids
Ensure prescribed walking aids are available and used correctly.
Communicate the risk
Make sure relevant staff understand the patient's current mobility needs.
After a fall
If a patient falls, assess before moving them
A fall should be treated as a clinical event requiring assessment, appropriate assistance and documentation.
Call for help and follow the local post-fall procedure.
Consider injury, pain, consciousness, observations and the circumstances surrounding the fall. Seek urgent clinical assistance if serious injury or deterioration is suspected.
Documentation
What should be recorded?
- Identified falls risks.
- Mobility and assistance requirements.
- Prevention measures in place.
- Changes in condition that alter falls risk.
- Any fall or near miss and the circumstances surrounding it.
- Post-fall assessment and escalation.
- Relevant communication with the wider clinical team.
Good documentation helps the next member of staff understand exactly
what the patient needs to move safely.
Student nurse focus
How to build confidence with falls prevention
Falls prevention becomes more intuitive when you look at the whole patient rather than treating risk assessment as a tick-box exercise.
- Learn the falls assessment process used in your placement area.
- Ask how mobility status is communicated between staff.
- Check whether assistance is needed before encouraging movement.
- Notice environmental hazards whenever you enter the bed space.
- Ask what changes would trigger reassessment.
- Understand the local procedure following a fall or near miss.
The aim is not to prevent movement. The aim is to support independence
while reducing avoidable harm.
Next clinical skill
Next: Moving and Handling Patients.
The next NurseNet guide explores safer movement, patient transfers, mobility equipment and individual risk assessment.
Continue to moving and handling