The iatrogenic nature of hospitalization places patients at risk of falling, injury, and death. In this article, the major principles of providing protective and preventive interventions are outlined. The principles are the establishment of a multifaceted fall prevention program that targets fall interventions according to each etiologic factor; the recognition that fall protective and prevention interventions are distinct and serve a different function; the use of the fall monitoring system comprehensively; the creation of a clinical nurse specialist position, responsible for fall intervention; and a conscious and individualized approach to fall prevention. The process and problems of the varying nature of providing fall protection and fall prevention are discussed; for example, use of a side rail as a protective strategy may be successful with one patient but considered a hazard when used with a different patient.