Comprehensive prevention program
One strategy does not fit all patients
In general, it has been difficult to study and evaluate the merits of specific interventions because of logistical considerations such as varying populations, simultaneously employed multiple interventions, and confounding variables. As falls appear to happen because of a complex interaction of intrinsic and extrinsic risk factors, interventions require a multi-faceted approach. A strong fall prevention strategy that encompasses a number of different interventions and targets multiple risk factors is more likely to be successful.
Thus, the success of a
program is not as dependent on a specific intervention
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The Florida Hospital Association’s Patient Steering Committee has provided a useful outline of the key components for a comprehensive program:
- Assessing and screening for risk factors for falls.
- Using triggers to implement a falls prevention protocol.
- Implementing protocols according to patient needs.
- Assessing and reassessing patient and modifying as appropriate.
- Reporting falls (internal and external).
- Measuring/monitoring fall rates.
- Improving the falls prevention program.
Additionally all staff should be required to complete competencies. As noted above, there is no single fall prevention care plan that will work for all patients and residents and for all situations or settings. Based on a falls risk assessment, the healthcare team should tailor patient-specific prevention strategies. As eloquently stated by Morse:
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“Because patients fall in a variety of situations, and these falls are due to innumerable causes, there cannot be one routinized care plan to prevent falls. Although some prevention strategies are obvious and may be used with many patients, other patients present more of a challenge and demand creative and innovative solutions to ensure patient safety.” |
Numerous resources, including the National Guideline Clearinghouse and the University of Texas Health Science Center, provide examples of frequently used fall prevention strategies identified in the literature.
Healthcare professionals who would like an in-depth review of the myriad of
specific intervention and prevention strategies should consider the following
resources. Note that there is significant overlap between interventions that may
be effective in acute versus long-term care settings, such as
environmental strategies
and reviewing
medications for
their risks/benefits and their proper dosages. Thus, one may want to research
each category as appropriate for a particular practice setting.
Guidelines and reviews in acute and long-term care settings.
Download
guidelines
- Falls in acute hospitals – A systematic review (Evans)
- Reducing patient falls in an acute general hospital (Barnet)
- Guideline for the prevention of falls in older persons (AGS)
- Prevention of falls and fall injures in the older adult (Registered Nurse Association Canada – full document)
- Summary of Recommendations
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