Falls in the surgical ward: incidence and characterization

Authors

DOI:

https://doi.org/10.29352/mill0220e.41849

Keywords:

critical care nursing; accidental falls; incidence; patient safety

Abstract

Introduction: Falls are the second leading cause of death from injuries worldwide and account for 21% of reported hospital incidents in Portugal. Prevention can reduce morbidity, mortality, and costs.

Objective: To determine the incidence and predictive factors of falls in surgical patients, as well as to identify the training needs of nurses in a Portuguese general surgery ward.

Methods: A quantitative, observational, cross-sectional, retrospective study involving patients admitted between 30/06/2023 and 30/06/2024 in a general surgery department of a Portuguese hospital.

Results: A total of 24 falls were recorded among 1300 patients, with a mean age of 78.04 years. The highest incidence occurred in patients aged ≥85 years. Falls peaked at five PM in June 2024 (29.2%). The average hospital stay was 33.67 days. The ward accounted for 45.8% of falls. Injuries occurred in 45.8% of cases, with severe harm in 37.5%. The average time from admission to fall was 18.8 days.

Conclusion: Falls have a significant impact on nursing care and hospital management. Strengthening nursing team training and implementing rigorous operational procedures for fall recording and prevention is essential.

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References

Alves, T., Silva, S., Braz, P., Papadakaki, M., Aniceto, C., Mexia, R., & Matias-Dias, C. (2025). Epidemiology of falls among older adults in Portugal: Analysis of unintentional injuries reported by a national emergency surveillance system. Healthcare, 13(10), 1160. https://doi.org/10.3390/healthcare13101160

Byrne, R., Patton, D., Moore, Z., O’Connor, T., Nugent, L., & Avsar, P. (2024). What is the impact of seasonal ambient changes on the incidence of falls among older adults? Working with Older People, 28(1), 34–43. https://doi.org/10.1108/WWOP-12-2023-0052

Costa-Dias, M. (2014). Quedas em contexto hospitalar: Fatores de risco [Tese de doutoramento, Universidade Católica Portuguesa]. Repositório Institucional da Universidade Católica Portuguesa. http://hdl.handle.net/10400.14/17112

Despacho n.º 9390/2021: Plano Nacional para a Segurança dos Doentes 2021 -2026, Gabinete do Secretário de Estado Adjunto e da Saúde (2021). Diário da República, Série II. https://files.dre.pt/2s/2021/09/187000000/0009600103.pdf

Direção-Geral da Saúde. (2022). Documento técnico para a implementação do Plano Nacional para a Segurança dos Doentes. https://l1nq.com/dBM7u

Direção-Geral da Saúde. (2023). Relatório anual de monitorização da implementação do Plano Nacional para a Segurança dos Doentes 2021-2026. https://sl1nk.com/o7jvJ

Fritz, B., King, C., Mehta, D., Somerville, E., Kronzer, A., Abdallah, A., Wildes, T., Avidan, M., Lenze, E., Stark, S., & ENGAGES Research Group. (2022). Association of a perioperative multicomponent fall prevention intervention with falls and quality of life after elective inpatient surgical procedures. JAMA Network Open, 5(3), e221938. https://doi.org/10.1001/jamanetworkopen.2022.1938

Hasan, B., Bechenati, D., Bethel, H. M., Cho, S., Rajjoub, N. S., Murad, S. T., Kabbara Allababidi, A., Rajjo, T. I., & Yousufuddin, M. (2025). A systematic review of length of stay linked to hospital-acquired falls, pressure ulcers, central line–associated bloodstream infections, and surgical site infections. Mayo Clinic Proceedings: Innovations, Quality & Outcomes, 9(3), 100607. https://doi.org/10.1016/j.mayocpiqo.2025.100607

James, S. L., Lucchesi, L. R., Bisignano, C., Castle, C. D., Dingels, Z. V., Fox, J. T., Hamilton, E. B., Henry, N. J., Krohn, K. J., Liu, Z., McCracken, D., Nixon, M. R., Roberts, N., Sylte, D. O., Adsuar, J. C., Arora, A., Briggs, A. M., Collado-Mateo, D., Cooper, C., Dandona, L., … Murray, C. J. L. (2020). The global burden of falls: Global, regional and national estimates of morbidity and mortality from the Global Burden of Disease Study 2017. Injury Prevention, 26(Suppl 1), i3–i11. https://doi.org/10.1136/injuryprev-2019-043286

Joint Commission International. (2025). Joint Commission International accreditation standards for hospitals including standards for academic medical center hospitals (8th ed.). Joint Commission International.

Kronzer, V. L., Willett, T. M., & Alvi, M. S. (2016). Review of perioperative falls. British Journal of Anaesthesia, 117(6), 720–732. https://doi.org/10.1093/bja/aew377

Magnuszewski, L., Wojszel, A., Kasiukiewicz, A., & Wojszel, Z. B. (2022). Falls at the geriatric hospital ward in the context of risk factors of falling detected in a comprehensive geriatric assessment. International Journal of Environmental Research and Public Health, 19(17), 10789. https://doi.org/10.3390/ijerph191710789

Montero-Odasso, M., van der Velde, N., Martin, F. C., Petrovic, M., Tan, M. P., Ryg, J., Aguilar-Navarro, S., Alexander, N. B., Becker, C., Blain, H., Bourke, R., Cameron, I. D., Camicioli, R., Clemson, L., Close, J., Delbaere, K., Duan, L., Duque, G., Dyer, S. M., & Freiberger, E. (2022). World guidelines for falls prevention and management for older adults: A global initiative. Age and Ageing, 51(9). https://doi.org/10.1093/ageing/afac205

Morris, M., Webster, K., Jones, C., Hill, A., Haines, T., McPhail, S., Kiegaldie, D., Slade, S., Jazayeri, D., Heng, H., Shorr, R., Carey, L., Barker, A., & Cameron, I. (2022). Interventions to reduce falls in hospitals: A systematic review and meta-analysis. Age and Ageing, 51(5), afac077. https://doi.org/10.1093/ageing/afac077

Nurul, A., & Andi Masyitha, I. (2024). Factors associated with the incidence of patient falls in hospitals: A scoping review. Journal of Integrative Nursing, 6(2), 117–126. https://doi.org/10.4103/jin.jin_133_23

Oda, S., Takechi, K., Hirai, S., Takatori, S., & Otsuka, T. (2023). Association between nocturnal falls and hypnotic drug use in older patients at acute care hospitals. European Journal of Clinical Pharmacology, 79(5), 753–758. https://doi.org/10.1007/s00228-023-03485-5

Ordem dos Enfermeiros. (2018). Regulamento n.º 429/2018: Regulamento de competências específicas do enfermeiro especialista em Enfermagem Médico-Cirúrgica na área de enfermagem à pessoa em situação crítica, na área de enfermagem à pessoa em situação paliativa, na área de enfermagem à pessoa em situação perioperatória e na área de enfermagem à pessoa em situação crónica [Regulamento]. Diário da República, Série II. https://dre.pt/application/conteudo/115698617

Randell, R., McVey, L., Wright, J., Zaman, H., Cheong, V., Woodcock, D., Healey, F., Dowding, D., Gardner, P., Hardiker, N., Lynch, A., Todd, C., Davey, C., & Alvarado, N. (2024). Practices of falls risk assessment and prevention in acute hospital settings: A realist investigation. Health and Social Care Delivery Research, 12(5), 1–224. https://doi.org/10.3310/JWQC5771

Romão, A. L., & Nunes, S. (2018). Quedas em internamento hospitalar: causas, consequências e custos: Estudo de caso numa unidade hospitalar de Lisboa. Portuguese Journal of Public Health, 36(1), 1–8. https://doi.org/10.1159/000488073

Van der Velde, N., Seppälä, L., Hartikainen, S., Kamkar, N., Mallet, L., Masud, T., Montero-Odasso, M., van Poelgeest, E., Thomsen, K., Ryg, J., Petrovic, M., & EuGMS Task Force on Fall-Risk-Increasing Drugs. (2023). European position paper on polypharmacy and fall-risk-increasing drugs recommendations in the World Guidelines for Falls Prevention and Management: Implications and implementation. European Geriatric Medicine, 14(4), 649–658. https://doi.org/10.1007/s41999-023-00824-8

Von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., Vandenbroucke, J. P., & STROBE Initiative. (2007). Strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. BMJ, 335(7624), 806–808. https://doi.org/10.1136/bmj.39335.541782.ad

World Health Organization. (2021). Step safely: Strategies for preventing and managing falls across the life-course. https://sl1nk.com/A8WF7

World Health Organization. (2024). Global patient safety report 2024. https://sl1nk.com/PT41X

World Health Organization. (2025). Incidence rate of falls in older people (per 100,000 population). In Maternal, newborn, child and adolescent health and ageing data portal. International Health Metrics and Evaluation. https://encurtador.com.br/urbKc

Yaghoubi, S., Ahmadi Gooraji, S., Habibi, M., & Torkaman, F. (2022). Fall incidence in hospitalized patients and prediction of its risk factors using a weighted Poisson model. Journal of Public Health, 30, 2971–2980. https://doi.org/10.1007/s10389-021-01476-3

Published

2025-11-11

How to Cite

Pires, B., & Lopes, T. (2025). Falls in the surgical ward: incidence and characterization . Millenium - Journal of Education, Technologies, and Health, 2(20e), e41849. https://doi.org/10.29352/mill0220e.41849

Issue

Section

Life and Healthcare Sciences