Studies that evaluated fall risk assessment tools for nurses, interventions to prevent falls, and common risk factors for falls, for psychiatric patients aged between 19 and 64 years, were eligible for inclusion. Participants had to have a mental illness diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases and Related Health Problems (ICD), or by the attending physician. The main outcome of interest was the number of patient falls in hospital. Studies of patients with intellectual disabilities were excluded.
All the included studies were of in-patients. The mean age of patients who fell, where reported, ranged from 38 to 68 years (range 16 to 108). The studies evaluated the effectiveness of a modified fall risk assessment tool, a fall protocol, a new hospital policy or intervention, and a revised fall assessment and prevention policy. The modified fall risk assessment tool consisted of age, history of falls, medications, mental status, physical status, orthostatic hypertension, gait and balance, and elimination. Fall prevention interventions included risk assessment on admission, regular observation, bed sensors, blood pressure monitoring, non-skid slipper socks, education brochure for patients, medical profile review by pharmacy staff, and annual staff education.
Two reviewers independently assessed studies for inclusion.