It’s often assumed that restricting patient activity can reduce the risk of falling. This, however, is a mistaken belief. According to recent research (*), hospital patients who fall do not walk around anymore than patients who don’t fall. In fact, keeping patients immobile can backfire; not moving enough can lead to poor muscle tone/decreased balance and increased fall risk.

To examine the incidence of falls among ambulatory and non-ambulatory elderly patients, researchers equipped 35 elderly patients with small electronic devices that recorded every step they took. They determined that there was no difference in the amount of walking between the two groups.

Nevertheless, they did find that falls were associated with delirium and/or poor cognitive function. Additionally, all of the falls took place at night, with 60% of falls related to trips to the bathroom.

Using a fall alarm is a good way to reduce the risk of ‘toileting falls’ at night. Nurses often rely on toileting rounds to detect patients needing to use the toilet. This strategy, however, is not very effective at night (no one wants to wake a sleeping patient and ask them if they need to use the bathroom) or in patients with poor cognition who may not be able to communicate their needs.

(*) Fisher SR, Galloway RV, Kuo YF, et al. Pilot study examining the association between ambulatory activity and falls among hospitalized older adults. Archives of Physical Medicine and Rehabilitation, 2011.