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Falls are the most frequently reported adverse event in hospitalised patients and carry a risk of great harm for the frail elderly. This intervention aimed to prevent high‐risk in‐patients on an acute aged care ward from falling.

Patients assessed at high falls risk were accommodated in a room staffed by volunteer companion‐observers. The volunteers engaged them in conversation, played cards, opened meals and used the call bell to summon nurses if patients attempted to move from the bed or chair without assistance. Because of occupational health and safety considerations, the volunteers did not assist patients to ambulate.

The falls rate in the acute aged care ward decreased by 44 percent (p<0.000). No patients fell in the observation room when volunteers were present. Relatives of participating in‐patients expressed appreciation of the volunteer role, in terms of increased safety and also companionship. Volunteers exercised initiative in determining their pattern of work and developing resources to support their role.

Because volunteers are not present around the clock, other strategies are needed to prevent wandering, frequently confused older in‐patients from falling during the night.

In a context where frail elderly patients need constant supervision, using volunteers is a reasonable strategy.

This intervention used an inexpensive, human resources‐based approach to significantly reduce the incidence of falls in the population at highest risk of falling. The additional benefits to patients in terms of cognitive improvement bear further investigation.

Falls are a significant burden on the Australian health care budget and can result in loss of personal independence, injury or death. A sustained high rate of inpatient falls in a 550‐bed acute care hospital has made it imperative for nurses to identify patients at highest risk, in order to implement preventive interventions. This study examined the prevalence of “intrinsic high risk” characteristics identified by the literature in people who fell during hospitalisation, to confirm the validity of these predictors in detecting risk. Over ten weeks 91 inpatients fell (total 118 falls) and were assessed for intrinsic risk factors. Most prevalent was impaired ambulatory status resulting in balance instability. Other high prevalence factors included cognitive impairment and age > 75. Commonly cited factors, such as urinary or faecal incontinence, medications and history of prior falls, were found less frequently. No significant differences in risk factors by gender were identified.