Model for Preventing Recurrent Falls in Older Adults in Hospitals: An Integrative Review

Abstract

     Effective prevention of recurrent falls among older adults in hospitals can reduce recurrent falls and improve their quality of life. This study aimed to analyze, synthesize, and integrate knowledge on models for preventing recurrent falls among older adults in hospitals. An integrative review was conducted using the PICO/PICo framework and included descriptive, exploratory, qualitative, and experimental studies. The review followed the five-step framework of Whittemore and Knafl (2005): problem identification, literature search and selection, quality appraisal, data analysis and synthesis, and presentation of findings. Studies published from 2016 to 2026 were searched in MEDLINE Complete, CINAHL Complete, ThaiJO, and Google Scholar. Of 1,119 identified studies, 11 were included and appraised using the Joanna Briggs Institute (JBI) critical appraisal tools (2022). The researchers verified the data and synthesized them using thematic analysis and narrative synthesis.      

     The research findings showed that the model for preventing recurrent falls among the elderly in hospital settings is multifactorial. This approach encompasses risk assessment, individualized care, risk factor management, education and engagement, environmental management, multidisciplinary team collaboration, and continuity of care. Implementation strategies are diverse and should be tailored to the elderly individuals' risk levels, functional capabilities, and specific contexts, ensuring a seamless continuum of care from the pre-discharge hospital phase through to the post-discharge period. Outcomes addressed include fall incidence and recurrence, fall risk, balance, physical performance, ability to perform activities of daily living, and fear of falling. Ultimately, the synthesized components should be applied in a context-specific manner rather than relying on a single, standardized model.      

     Research findings indicate that preventing recurrent falls among the elderly should be addressed through a holistic, multifactorial approach to care. Nurses play a pivotal role in assessment, care planning, coordination, and continuous monitoring from the hospital to the home setting. The synthesized elements should be developed and adapted into individualized care guidelines tailored to the specific service context and accompanied by post-discharge follow-up; furthermore, experimental research should be conducted to systematically evaluate the effectiveness of these guidelines.