Abstract

Background. In-hospital falls are a common patient safety concern associated with multiple concurrent patient-related, environmental,
and situational factors. Scale-based risk assessment alone may not adequately capture all factors influencing fall risk, highlighting the need for a more comprehensive and individualized approach.
Objectives. The aim of the study was to develop an in-hospital fall prevention strategy at the North Estonia Medical Centre related risk profiles before and after the implementation of a Multifactorial Falls Risk Assessment (MFRA) tool.
Methods. The study consisted of a description of the stepwise development of an in-hospital fall prevention strategy and a retrospective data analysis. The analysis included in-hospital fall incidents from 2023 and 2024. Data were analysed using descriptive statistics.
Results. Between 2021 and 2024, a stepwise fall prevention strategy was developed, and fall-related risk profiles were analysed. Falls occurred predominantly among highrisk patients; however, incidents were also observed in patients classified as low and moderate risk. The implementation of the MFRA tool enabled a more detailed characterization of fall risk profiles and facilitated the identification of the combined effects of multiple concurrent risk factors.
Conclusion. In-hospital fall risk is inherently multifactorial, and scale-based assessment alone may not adequately capture this
complexity. The MFRA tool supports prevention based on the patient’s individual risk profile but is not a standalone intervention for reducing falls. Effective prevention requires a comprehensive and systematic approach in which risk assessment is only one component of a broader prevention strategy.