Prevention of falls and consequent injuries in elderly people

Kannus, Pekka; Sievänen, Harri; Palvanen, Mika; Järvinen, Teppo L. N.; Parkkari, Jari

doi:10.1016/s0140-6736(05)67604-0

Cited by 916 publications

(641 citation statements)

References 121 publications

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“…[1][2][3][4] Previous studies have reported that independent ambulatory patients with SCI encounter a high-risk of falls (74-75%). 2,5 The incidence is clearly higher than that reported in the elderly (33%) 6,7 and patients with other neurological disorders such as stroke (37-73%) 8,9 and Parkinson's diseases (51-68%). 10,11 After falls, 18% of subjects with SCI reported fracture and 45% had restricted ability to get out into communities and engage in a productive activity.…”

Section: Introductionmentioning

confidence: 86%

Falls in independent ambulatory patients with spinal cord injury: incidence, associated factors and levels of ability

2012

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Study Design: A 6-month retrospective study. Objectives: To investigate incidence and factors associated with falls in independent ambulatory patients with spinal cord injury (SCI), and to compare levels of ability in those with and without a history of falls. Setting: A tertiary rehabilitation center and community hospitals. Methods:Seventy-seven independent ambulatory subjects with SCI were interviewed for fall data during 6 months before participation in the study. Subjects were also assessed for their functional ability using the timed up and go test (TUGT) and the 6-min walk test (6MinWT). Results: Twenty-six subjects (34%) reported falls during 6 months (range 1-6 times). After falls, two subjects required medical attention due to wrist joint fracture and back pain. Walking without a walking device significantly increased the risk of fall, whereas using a walker significantly reduced the risk of fall (Po0.05). Moreover, faller subjects showed significantly better levels of ability than the non-faller subjects (Po0.005 for the TUGT and Po0.05 for the 6MinWT).Conclusion: Approximately one-third of the independent ambulatory subjects with SCI experienced falls. Notably, faller subjects had better functional ability than the non-faller subjects. Thus, apart from emphasizing the ability to walk independently, rehabilitation professionals may need to seek strategies that improve balance and safety.

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Section: Introductionmentioning

confidence: 86%

Falls in independent ambulatory patients with spinal cord injury: incidence, associated factors and levels of ability

2012

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“…A recent study stated that 89.1% of external cause deaths of nursing home residents were due to falls (Ibrahim et al, 2015). Besides physical complications, falls lead to psychological consequences, such as fear of falling, depression, and social isolation (Kannus et al, 2005;Rubenstein and Josephson, 2002). Furthermore, falls are associated with extensive healthcare costs (Burns et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Implementation of fall prevention in residential care facilities: A systematic review of barriers and facilitators

Vlaeyen

Stas

Leysens

et al. 2017

International Journal of Nursing Studies

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Objectives: To identify the barriers and facilitators for fall prevention implementation in residential care facilities. Design: Systematic review. Review registration number on PROSPERO: CRD42013004655. Data sources: Two independent reviewers systematically searched five databases (i.e. MEDLINE, EMBASE, CINAHL, PsycINFO, and Web of Science) and the reference lists of relevant articles. Review methods: This systematic review was conducted in line with the Center for Reviews and Dissemination Handbook and reported according to the PRISMA guideline. Only original research focusing on determinants of fall prevention implementation in residential care facilities was included. We used the Mixed Method Appraisal Tool for quality appraisal. Thematic analysis was performed for qualitative data; quantitative data were analyzed descriptively. To synthesize the results, we used the framework of Grol and colleagues that describes six healthcare levels wherein implementation barriers and facilitators can be identified. Results: We found eight relevant studies, identifying 44 determinants that influence implementation. Of these, 17 were facilitators and 27 were barriers. Results indicated that the social and organizational levels have the greatest number of influencing factors (9 and 14, respectively), whereas resident and economical/political levels have the least (3 and 4, respectively). The most cited facilitators were good communication and facility equipment availability, while staff feeling overwhelmed, helpless, frustrated and concerned about their ability to control fall management, staffing issues, limited knowledge and skills (i.e., general clinical skill deficiencies, poor fall management skills or lack of computer skills); and poor communication were the most cited barriers. Conclusion: Successful implementation of fall prevention depends on many factors across different healthcare levels. The focus of implementation interventions, however, should be on modifiable barriers and facilitators such as communication, knowledge, and skills. Effective fall prevention must consist of multifactorial interventions that target each resident's fall risk profile, and should be tailored to overcome context-specific barriers and put into action the identified facilitators.© 2017 Elsevier Ltd. All rights reserved.What is already known about the topic? Multifactorial interventions, tailored to each resident's fall risk profile, can reduce the number of falls and recurrent fallers under highly controlled circumstances, but seems to be ineffective under "real-world" conditions, presumably due to poor implementation.Successful implementation of complex, multifactorial interventions in clinical practice involves a tailored, multifaceted approach based on a good understanding of barriers and facilitators for implementation. No reviews exist that comprehensively summarize the evidence on fall prevention implementation barriers and facilitators in residential care settings. What this paper addsSeventeen facilitators and 27 barriers that ...

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“…In the 34 wk follow-up, 44 percent of those receiving the intervention suffered injurious falls compared with 56 percent in the control group. Kannus et al stressed the importance of selecting the right interventions (e.g., vitamin supplements, hip protectors) for the residents who were most likely to benefit from the intervention(s) [24].…”

Section: Introductionmentioning

confidence: 99%

Sociotechnical probabilistic risk modeling to predict injurious falls in community living centers

Powell‐Cope¹,

Campbell²,

Hahm³

et al. 2016

J Rehabil Res Dev

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Abstract-The goal of this study was to apply sociotechnical probabilistic risk assessment to prioritize risks and prevention strategies for serious injurious falls of residents in nursing homes. Risk modeling teams consisted of 26 clinical and nonclinical staff from three Department of Veterans Affairs community living centers and one state Veterans' nursing home. Participants met in groups several times to identify and assign probabilities to provider and resident at-risk behaviors and equipment failures. They identified prevention strategies for the failures that accounted for the highest levels of risk. Six scenarios were modeled: (1) transferring from bed to wheelchair, (2) propelling from bedside to bathroom, (3) transferring from wheelchair to toilet, (4) transferring from toilet to wheelchair, (5) propelling from bathroom to bedside, and (6) transferring from wheelchair to bed. The greatest paths of risk were for residents with impaired mobility and high fragility. A 26% reduction in injurious falls could be achieved by (1) reducing the number of unassisted transfers through a modest improvement in response time to alarms, (2) installing automatic brake locks on 90% of wheelchairs, (3) making the wheelchair maintenance process highly reliable, and (4) decreasing improper transfer techniques by 10%.

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Prevention of falls and consequent injuries in elderly people

Cited by 916 publications

References 121 publications

Falls in independent ambulatory patients with spinal cord injury: incidence, associated factors and levels of ability

Falls in independent ambulatory patients with spinal cord injury: incidence, associated factors and levels of ability

Implementation of fall prevention in residential care facilities: A systematic review of barriers and facilitators

Sociotechnical probabilistic risk modeling to predict injurious falls in community living centers

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