Background Falls are a significant concern in healthcare settings. While comprehensive strategies to prevent falls are employed in hospitals, there is a lack of information regarding falls within inpatient palliative care units.

Method This retrospective cohort study analysed fall incidence, characteristics and outcomes in a metropolitan inpatient palliative care unit over a 1 year period. Falls were identified using the online incident reporting system and patient characteristics, fall risk assessment and prevention measures were obtained through the electronic patient records.

Results During the study period, there were 61 falls by 51 patients out of a total of 525 admitted patients. The incidence of falls was 9.7% and the rate of falls was 5.8 falls per 1000 bed days for all admitted patients. Though more than half of falls resulted in no injury, 41% of patients with falls died within a week post-fall. Fall risk assessment was completed for 97% of patients at the time of the fall.

Conclusion This study contributes to the understanding of falls in inpatient palliative care units. Fall risk assessment and prevention measures did not appear to alter the rate of falls among patients who fell. Fall prevention strategies need to be tailored to meet patient autonomy, end of life goals and maintain healthcare standards.