Stools are a common source of falls for patients,
visitors and staff. These chairs are not meant for long-term
seating and are primarily used by staff. However, when left
unattended, patients or their visitors will seek the vacant seat
to rest or relax if all others are occupied. According to the
Agency for Healthcare Research and Quality (AHRQ), between
700,000 and 1,000,000 people in the nation fall in hospitals each
year. Stool falls reported in the CHPSO database were all
unassisted and often led to visits to the ED for fractures or
This is a sampling of the cases in the CHPSO database involving
Father of infant fell with infant in his arms while trying to
sit on a rolling stool. Infant unharmed.
Patient woke up to void in urinal at bedside and leaned
forward to brace himself on doctor’s wheeled stool. Stool slid
from underneath him and he slid on the floor. He scraped his
shoulder on the bedside rail. Subsequently, doctor’s stools were
removed from all patient areas.
Patient’s family member was on a cell phone call in the
hallway and sat down on a wheeled stool that was meant for staff.
He got up from the stool and fell forward landing on his knee
with both upper extremities outstretched to support his upper
body from falling; his right leg was stretched out from under his
Patient was sitting down and misunderstood nurse’s order not
to get up. The patient stood up and attempted to sit back down on
the wheeled stool. The patient leaned back against the stool and
slid backwards; she fell on her right side. X-rays were taken.
Patient was sitting on a wheeled stool by the nurse’s station
while eating. She moved and fell on her knees. Patient was
examined in the ED; no injuries were sustained.
Patient’s spouse was attempting to sit on wheeled stool and
the stool rolled away from her, falling to the floor. Patient had
a small amount of lower back pain and was sent to the ED.
Patient attempted to sit on wheeled stool and the stool
rolled away. The patient fell on his left side. The patient used
to lean on the wall and hold onto the handle bar to rest but this
time the patient wanted to sit on the stool found in the hallway.
Nurse was sitting on a stool at the bedside. The nurse
finished bandaging the patient and suddenly the solder joint
broke, separating the round seat from the wheeled base of the
stool leaving a sharp edge. The nurse landed on the floor. Others
quickly came to investigate due to the loud noise as the nurse
also knocked a bottle of sterile water off of a stand.
Engineering was notified who stated that they would dispose of
the stool as it was irreparable.
Patient was instructed to stay in wheelchair but ignored
instructions and tried to sit on wheeled stool used by
physicians. Patient fell, incurring a small laceration on the
Tech performed study for bilateral hand and knee films. Tech
sat the patient down on an exam stool with wheels to get the
patient to the exam table to perform the bilateral hand study.
When the tech was walking to the workstation to get set up for
the study, the tech heard the stool wheels move but did not hear
or see the patient fall off of the stool. Patient complained of
lower back pain. Nurse assessed patient who was transferred to
the ED via wheelchair.
Suggestions for purchasing stools
There are ways to prevent falls from occurring at your
organization when wheeled stools are involved:
Avoid stools with casters if at all possible or purchase
stools with safety brakes on the casters.
Avoid three-legged stools for stability.
Stools with padded armrests provide more comfort and support,
especially if spending a lot of time sitting on the stool.
If wheeled stools are necessary, CHPSO suggests keeping
stools away from patients and labeling them so patients do not
Given that stool falls commonly occur when unassisted, prevention
efforts can be made by increasing staff assistance and awareness
in the units. It is important to target the prevention efforts to
patients or visitors who may be at risk, such as the elderly and
infants being carried by visitors. Falls from stools can cause
serious injuries and the entire clinical staff should work
together to prevent them.