Preventing Falls in Older Adults in Aged Care Settings: Evidence-Based Strategies

Best practice recommendations for
prevention falls in older adults in an
aged care settingBackground
• The aged care setting refers to a health system that offers a plethora of
healthcare options to older adults, with the aim of meeting their different care
needs. Hence, the primary objective of healthcare workers present in aged care
settings is to improve the wellbeing and health of all older adults, while
providing them a safe environment (1).
• Patient safety has been identified as the cornerstone of superior quality health
care. Most of the work that defines patient safety and related practices that
avert harm have focus on undesirable consequences of care, such as,
morbidity and mortality. Nurses play a critical role in the coordination and
surveillance of the care services, in order to eliminate chances of adverse
health outcomes (2).
• While in most hospitals, patient safety is considered as a central priority, there
is a lack of collaborative work between teams in other aged care settings.
Presence of an experienced and strong healthcare team works towards
reducing the rates of infection, thereby imposing a check on mistakes that
violate the safety of the patients. This is usually achieved with the help of
effective communication between the hospital staff, families, and the service
users.
• Falls in aged care setting is one major issue related to patient safety that has
gained tremendous attention in the past decades. Falls in the healthcare
setting has been identified as a noteworthy cause of mortality and morbidity,
besides being categorised as a central type of preventable or avoidable
injuries. While the reason for falls in aged care setting is multifactorial, this
requires delivery of care in association with a multidisciplinary approach (3).
Hence, the key aim of workers in aged care setting is focused on preventing
future falls among the aged patients and treating all forms of injuries that occur
due to such circumstances. While 30-50% of fall related incidents in aged care
settings threaten the patient safety and lead to bruises, lacerations, and
abrasions, some of them even prove fatal and lead to fracture of the bones or
intracranial injuries (4). Hence, the primary aim is to conduct an extensive
search of article on fall prevention strategies that are effective in aged care
settings.
Search strategy and critical appraisal
A PICO framework was adopted for the formulation of the research question.
The research question is as follows;
Are fall prevention exercise effective in reducing fall related injuries and
providing patient safety in aged care settings?
The different components of the PICO question are given below:
P Older adults in aged care settings
I Fall prevention exercise
C Usual care
O Reduced fall related injuries
Two electronic databases namely PubMed and CINAHL were used for searching
the relevant literature with the use of specific key terms namely, ‘fall’,
‘injuries’, ‘elderly’, ‘older adults’, ‘prevention’, ‘exercise’, and ‘management’.
English published articles from 2013 till date were retrieved, followed by
assessment of their title and abstracts (5). This was followed by appraisal of
the articles with the use of the CASP critical appraisal tool.
Summary of evidence
The outcomes presented in the poster show a constructive
consequence of exercise on detrimental falls in aged people,
including the minor falls as well as those that need immediate
medical attention. These results should deliver useful
supplementary proof for healthcare workers to encourage
contribution in exercise based fall deterrence programmes, and
additional reasoning for decision makers to afford funding.
Recommendations
All healthcare workers present in aged care setting should
implement exercise programs to prevent falls and violation of
patient safety in older people.
Evidence bottom line statement
Exercise programs alone are insufficient to enhance safety of
older adults who are susceptible to falls. There must be other
provisions for safety devices, medication monitoring, vitamin D
supplementation, and reviewing the living conditions.
Limitations
It is clear that heterogeneity exists between the different aged care settings
and the fall prevention exercises that are implemented in them, across the
globe. Although the articles solely focused on fall prevention exercises to
improve patient safety, the interventions selected were moderately diverse in
terms of the intensity, duration, frequency, and delivery of the exercises
Implementation to practice
Barriers Strategies
Falls normalised by older
people
Enforcing a community based
fall prevention programme and
active health promotion
Denial in accepting fall
related advice
Care coordination to make them
learn about the impacts of the
hazard and potential
advantages of the intervention
Lack of fall education Delivery of comprehensive fall
education material, pamphlets,
posters, booklets or videos
Source- (12)
Source- (14)
Source- (13)