Every hospital has risk assessment and fall prevention protocols, yet every hospital has patients falling out of bed, while walking, during transfer, from a chair, from the portable commode, from the toilet, from a seated position, while taking a shower, and while dressing. A great many of those accidents result in serious and sometimes fatal injuries, such as hip fractures, skull fractures, brain hemorrhage, rib fractures, and the like.

In a court case, the question of liability rests with whether the fall was preventable. Most cases are the result of negligence where the staff members dropped the patient, forgot to put up the side rails, or failed to answer the call buzzer in a timely manner. Nonetheless, given the current state of affairs, hospital personnel cannot prevent all falls.

Thus even if a nurse takes all reasonable precautions and answers the call bells immediately, the patient could still plunge to the floor and no one person is legally to blame. Yet every accident has its cause and effect, so even when there is no specific negligence according to current standards, it is socially irresponsible to accept a certain percentage of falls as inevitable. And it seems especially irresponsible if it's you or someone you love who has fallen.

Hospitals need further investigation to find out what design flaws exist or what is lacking in the patient's environment that allows a sick person to slip out of bed undetected until the staff members hear the awful sound of someone hitting the floor or crashing into one of the furnishings and/or equipment items. Motion sensor and video surveillance technology has become wireless and inexpensive. With such devices, an alarm would go off every time a patient at risk placed an arm or leg off the bed. These patients would be mostly ambulatory elderly to whom the nurses gave instructions to call for assistance before getting out of bed.

Meanwhile, if you as the patient or family member as an advocate engage the staff and express your concern about the dangers of falling, this will heighten their awareness. Likewise, hospital management can also help to reduce incidence of falling by launching education campaigns warning new patients and family members about the possibility of falling and teaching what steps to take to maintain safety. They should hand out pamphlets and put up signs in the lobby and all the corridors. Fall prevention needs to be a cooperative effort between patients, family, and hospital executives and staff.