Assessment & Interventions | Recommendations |
---|---|
Assessment of Fall Risk | All patients admitted to hospitals should undergo falls risk assessment at the point of admission, within 24 hours, to identify those at higher risk of falls. |
 | Risk assessment should be multi-dimensional and include medical, functional and behavioral assessments of patients. No one risk screening tool alone will identify all persons at risk or risk factors. |
 | In acute care settings, reassessment of fall risk should be carried out at least twice a week and when there is a change in patient's status or environment. |
Risk Factors Contributing to Falls | A fall risk assessment should include the following: |
 | • Medical |
 |    - History of falls |
 |    - Medications associated with increased falls risk |
 |    - Secondary or specific diagnoses known to affect fall risk |
 |    - Postural hypotension |
 |    - Seizures, dizziness, vertigo |
 | • Functional |
 |    - Altered mental status |
 |    - Altered elimination status |
 |    - Impaired/deterioration of activities of daily living |
 |    - Impaired mobility or gait |
 |    - Poor visual acuity |
 | • Behavioral |
 |    - Poor safety awareness |
 |    - Lack of insight into own health condition |
 |    - Risk taking behavior |
Multifactorial Falls Prevention Approach | A falls prevention programme should comprise multifactorial interventions incorporating both general and individual-specific/tailored strategies: |
 |    ▪ Environment safety |
 |    ▪ Identification systems |
 |    ▪ Interventions for patients with altered mental status |
 |    ▪ Interventions for patients with altered elimination status |
 |    ▪ Mobility and exercise |
 |    ▪ Medication review |
 |    ▪ Education |
 | The fall prevention programme should involve all members of the multi-disciplinary healthcare team. |
Post Fall Analysis and Management | All patients who experience an inpatient fall should undergo a post-fall assessment. |
 | The post-fall assessment should be accompanied by: |
 |    ▪ Attention to patients' injuries |
 |    ▪ Medical review to exclude acute causes of fall |
 |    ▪ Investigation into the circumstances of fall |