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Falls risk assessment and prevention in older people in healthcare facilities

03 April 2025
Volume 34 · Issue 7
Nurse helping the elderly

Abstract

Falls among older adults in healthcare facilities are a significant cause of injury and morbidity, with serious implications for patient health and healthcare costs. This article provides an in-depth review of falls risk assessment tools and prevention strategies, emphasising the multifactorial nature of falls, which include intrinsic factors such as medical conditions and extrinsic factors such as environmental hazards. The article discusses widely used risk assessment tools in the UK, including the Morse fall scale, Stratify, and the timed up and go test, and highlights the importance of a comprehensive, multidisciplinary approach to fall prevention. Evidence-based strategies such as environmental modifications, exercise programmes, medication reviews, and patient education are explored. The article concludes that ongoing assessment, staff training and the integration of technology are vital in reducing falls and improving patient safety in healthcare settings.

Falls are a significant cause of injury and morbidity among older adults, particularly those residing in healthcare facilities such as hospitals, nursing homes and long-term care institutions. Globally, one-third of individuals aged 65 and older experience a fall annually (National Institute for Health and Care Excellence (NICE), 2013; Ganz and Latham, 2020). Approximately half of these individuals will suffer recurrent falls (World Health Organization (WHO), 2021). Salari et al (2022) indicated the prevalence of falls in older people in the world to be 26.5%.

Falls often lead to adverse outcomes, including fractures, head injuries, decreased functional independence and, in some cases, death (Seppala and van der Velde, 2023; Sturnieks et al, 2024). Total deaths and disability-adjusted life years (DALYs) due to falls have increased gradually since 1990 in Europe (Haagsma et al, 2020), with 38 million DALYs lost each year globally (WHO, 2021). The financial burden of falls to the NHS was estimated to be more than £2.3 billion per year (NICE, 2013). Therefore, prevention of falls is a critical concern in older person care, and healthcare systems have prioritised reducing fall-related injuries among the elderly (Cameron et al, 2024; Camp et al, 2024).

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