Welcome to the October edition of the Falls Prevention Alliance Newsletter, the year feels like it is flying by! It is lovely to have some warmer weather and longer days.
In June we held a workshop with people responsible for overseeing falls prevention in their hospital or health service. The group discussed what is currently being done to prevent falls, some of the challenges and what opportunities there are to work together to prevent falls. We look forward to working with this group to reduce falls in Victorian hospitals.
The long-awaited World Guidelines for Falls Prevention and Management have also been released and we are currently exploring ways to support the dissemination and implementation of these guidelines.
We are also continuing to address some of the questions raised in our seminar series from earlier this year; this time we will explore the differences between falls risk screening and falls risk assessment
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Kind regards,
Associate Professor Cathy Said
Chair
Falls Prevention Alliance
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- Meet our committee members
- Guidelines and resources
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- Your falls questions answered
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Meet our committee members
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Terry Haines – Committee Member
Professor Terry Haines has the role of Head of School, School of Primary and Allied Health Care at Monash University. He has been conducting falls prevention research since graduating as a physiotherapist and has led many of the largest trials to prevent falls in hospitals internationally.
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Global falls guidelines released
The ‘World Guidelines for Falls Prevention and Management for Older Adults: A Global Initiative’ have been published. These guidelines were developed by the World Falls Task Force, which assembled 96 multidisciplinary experts from 39 countries across 5 continents. The World Guidelines for Falls aim to provide a framework and expert recommendations to healthcare and other professionals working with older adults on how to identify and assess the risk of falls. They recommend which interventions, alone or in combination, should be offered to older people as part of a person-centred approach to preventing and managing falls and include specific recommendations for falls prevention in hospital.
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Falls prevention resources
The Centre of Research Excellence Prevention of Falls Injuries has a range of free, accessible pre-recorded presentations on falls, including falls prevention in hospital.
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Your falls questions answered
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Question: What is the difference between a falls risk screen and a falls risk assessment?
Answer: A falls risk screening tool is used to quickly identify whether someone may be at risk of falls. Typically these consist of several questions and are scored; a patient is classified as being at high or low risk of falls based on the score. People classified at high risk of falls have a more detailed fall assessment. A falls risk assessment is an assessment of a person’s individual risk factors. Assessment findings are used to guide interventions to reduce a person’s risk of falls. It can be confusing as some tools are called assessment tools and may assess risk factors (e.g. cognition or mobility status) but are used as screening tools.
Evidence indicates that scored falls risk screening tools are not useful at identifying who is at risk of falls in hospitals.(1) Two recent studies demonstrated no increase in falls when you stopped using a scored falls risk screening tool. (2,3) Everyone over 65 years of age in hospital should be considered at risk of falls. (4) Younger people with specific health conditions that increase falls risk such as neurological disorders, stroke, cognitive impairment/delirium, hip fractures, or anyone that clinicians think is 'at risk' of falls should also be considered at risk. These groups should have a multifactorial falls risk assessment and appropriate strategies put in place to reduce risk.
References:
1. Haines TP, Hill K, Walsh W, Osborne R. Design-related bias in hospital fall risk screening tool predictive accuracy evaluations: systematic review and meta-analysis. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2007 Jun 1;62(6):664-72.
2. Morris ME, Haines T, Hill AM, Cameron ID, Jones C, Jazayeri D, Mitra B, Kiegaldie D, Shorr RI, McPhail SM. Divesting from a scored hospital fall risk assessment tool (FRAT): A cluster randomized non‐inferiority trial. Journal of the American Geriatrics Society. 2021 Apr 9.
3. Jellett J, Williams C, Clayton D, Plummer V, Haines T. Falls risk score removal does not impact inpatient falls: A stepped‐wedge, cluster-randomized trial. Journal of Clinical Nursing. 2020 Dec;29(23-24):4505-13.
4. Montero-Odasso M, van der Velde N, Martin FC, et al. World guidelines for falls prevention and management for older adults: a global initiative. Age Ageing. 2022;51(9).
Do you have a question about preventing hospital falls? Email cathie.pigott@monash.edu to submit a question.
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