Programs Falls Prevention

Falls are common among older people and often result in fractures or other serious injuries. Fall related injury is a major cause of morbidity and mortality for older people. Between one in four and one in three community dwelling people aged 65 years or over report at least one fall per year and many fall more than once. Fall injury is a major cause of injury-related hospitalisations and loss of independence among people aged 65 years and over in NSW.

In NSW each year, falls lead to approximately 30,000 hospitalisations and at least 300 deaths in people aged 65 years and over. Rates of fall related age-standardised hospitalisations have continued to steadily increase. Fall related hospital separations in people aged 65 years and over have increased by 2.5% per annum for males and 0.9% per annum for females over the past ten years.

Patient falls are the most common adverse event reported in acute care settings, affecting between 2% to 10% of annual hospital admissions. In line with international experience, in-hospital falls represent a significant high cost, high volume hospital acquired condition within NSW hospitals. Patient falls in hospitals increases length of stay, requires additional diagnostic investigations and impacts on patient treatment resulting in increased costs to the system.

Hospital stays and rehabilitation are lengthy and expensive and having had a recent fall is one of the leading reasons for premature admission to permanent residential aged care. No other single injury cause, including road trauma, costs the health system more than fall injury.

NSW Falls Prevention Program Key Focus:

• Reduce fall injury in older people and fall related admission to hospital;
• Implementation of a range of strategies preventing falls across hospital, community and residential aged care settings.

Key Focus Areas

• Hospital sector:
  • Identification of people at risk for falls (screen and assessment) and implementation of strategies to care for people at risk
  • Implementation of post-fall guideline following a fall in hospital
  • Reporting and monitoring of fall incidences, and providing feedback to ward staff
  • Implementation of the Australian Safety Quality Commission best-evidence falls prevention guidelines for Hospital. Revised evidence based guidelines will be available at the end of 2009.
• Community sector:
  • Forming links with other agencies to build a network of exercise programs (community and home-based) with a focus on balance and strength training.
  • Early identification of falls risk factors and implementation of strategies to care for people at risk that includes referral to suitable programs by community health teams, GPs, Ambulance Service NSW and community service providers.
  • Implementation of the Australian Safety Quality Commission best-evidence falls prevention guidelines for Hospital. Revised evidence based guidelines will be available at the end of 2009.
• Residential Care:
  • Supporting the residential care sector in regards to the implementation of the Australian Safety and Quality Commission falls best-practice guidelines for residential aged care facilities. Revised evidence based guidelines will be available at the end of 2009.

References:

Bradley C and Harrison JE, Fall related hospitalisations among older people sociocultural and regional aspects. Injury research and statistics, Series number 33 (AIHW cat.no. INJCAT 97) Adelaide: AIHW, 2007.

Population Health Division, The Health of the people of New South Wales - Report of the Chief Health Officer, Sydney: NSW Department of Health, 2007.

NSW Falls Prevention Network

The purpose of the network is to share falls prevention knowledge, expertise, and resources across the three settings mentioned above. The role of this network includes:

• Forums for discussion of falls related issues;
• Dissemination of models of good practice, a bi-monthly newsletter and research findings both local and international.

To join visit the NSW Falls Prevention Network website.