Although falling may seem like a simple event, in reality it is a complex medical issue leading to serious injuries including fractures, lacerations, soft tissue and traumatic brain injuries, and even death. The Nurses Improving Care for Health System Elders (NICHE) guideline for falls prevention in acute care unit was formulated by incorporating recommendations from systematic reviews of the literature and advice from expert consensus. Recommendations include pre-fall risk assessment, utilization of a post-fall assessment tool, follow-up monitoring for 48 hours, and implementation of an individualized, multidisciplinary plan of care to address treatable problems that contributed to the fall and to prevent future falls. The guideline also calls for staff education.