This best practice guideline outlines evidence-based approaches for preventing falls and reducing fall injuries for adults aged 18 or older receiving care from nurses and other health-care providers.
This best practice guideline outlines evidence-based approaches for preventing falls and reducing fall injuries for adults aged 18 or older receiving care from nurses and other health-care providers.
As an introduction, we’ve provided summaries of the practice recommendations from the BPG document — but we strongly encourage downloading RNAO’s official PDF.
Screen all adults to identify those at risk for falls. Conduct screening as part of admission processes, after any significant change in health status, or at least annually. Screening should include the following approaches:
For adults at risk for falls, conduct a comprehensive assessment to identify factors contributing to risk and determine appropriate interventions. Use an approach and/or validated tool appropriate to the person and the health-care setting.
Refer adults with recurrent falls, multiple risk factors, or complex needs to the appropriate clinician(s) or to the interprofessional team for further assessment and to identify appropriate interventions.
Engage adults at risk for falls and fall injuries using the following actions:
Provide education to the person at risk for falls and fall injuries and their family (as appropriate) in conjunction with other falls prevention interventions. This includes providing information about risk for falls, falls prevention, and interventions. Ensure that the information is provided in a variety of formats and in the appropriate language.
Communicate the person’s risk for falls and related plan of care/interventions to the next responsible health-care provider and/or the interprofessional team at all care transitions to ensure continuity of care and to prevent falls or fall injuries.
Implement a combination of interventions tailored to the person and the health-care setting to prevent falls or fall injuries.
Recommend exercise interventions and physical training for adults at risk for falls to improve their strength and balance. Encourage an individualized, multicomponent program/activity that corresponds to the person’s current abilities and functioning.
Collaborate with prescribers and the person at risk for falls to reduce, gradually withdraw, or discontinue medications that are associated with falling, when the person’s health condition or change in status allows. This includes the following actions:
Refer adults at risk for falls or fall injuries to the appropriate health-care provider for advice about vitamin D supplementation.
Encourage dietary interventions and other strategies to optimize bone health in adults at risk for falls or fall injuries, particularly those at risk for fracture. Refer to the appropriate health-care provider for advice and individualized interventions.
Consider hip protectors as an intervention to reduce the risk of hip fracture among adults at risk for falls and hip fracture. Review the evidence, potential benefits, harms, and barriers to use with the person to support individualized decisions.
After a person falls, provide the following interventions:
This website was developed by a team of researchers at the Daphne Cockwell School of Nursing at Toronto Metropolitan University (Formerly Ryerson University). The purpose of the site is to provide supplementary resources for implementing RNAO’s Best Practice Guidelines. Some information about the best practice guidelines has been collected directly from the RNAO BPG website. We have done our best to ensure accuracy, however some discrepancies may occur. For official, up-to-date information about the best practice guidelines, please refer to the RNAO website.
