Assess and manage fall risk in residents

• Screen all new residents to identify those at risk for falls and their fall risk factors; determine appropriate interventions
  Appendix to RNAO resource:Approaches and Tools for Assessing Falls Risk by RNAO
  RNAO Clinical Pathways: Admission Assessment
• Ensure that each resident has an individualized plan of care for fall prevention; reassess residents after any major health change or at least once a year
  Provincial Geriatrics Leadership Ontario’s Fracture Prevention in Long-Term Care (Toolkit)
• Complete postfall assessments to identify contributing factors and prevent reoccurrence
  Alberta Health Services Falls Risk Management Post‐Falls Review recommendations
• Implement fall rounds for residents at high risk of falls
  Comfort care rounds
  Health Quality Innovation Network’s 4P’s approach: Pain, Position, Placement, and Personal Needs
  Canadian Nurse article: Purposeful Hourly Rounding in long-term care

Implement universal fall precautions

• Complete an environmental safety checklist for each new resident upon move-in
  
• Conduct ongoing surveillance of resident spaces to promptly clean up environmental hazards like clutter, spills, and trip hazards
  Appendix to RNAO resource:Components and Example of Universal Falls Precautions
• Identify and modify equipment and other factors in resident spaces that could contribute to falls (e.g., improve lighting in room, install night lights)
• Implement the use of devices and equipment (such as low-profile beds, bed and chair alarms, and grab bars) that can help reduce the risk of falling
  

Follow best-practice rehabilitation care pathways

• Use evidence-based tools to identify individuals living with or at risk of frailty
  Provincial Geriatrics Leadership Ontario and the Ontario Collaborative for Aging Well have identified recommended frailty screening tools that can be integrated into various care settings
• Implement evidence-based care pathways for rehabilitation
  Provincial Geriatrics Leadership Ontario:Framework for Rehabilitative Care for Older Adults Living With or at Risk of Frailty
• Incorporate strengthening or balancing exercises in resident care plans to help prevent falls
  HealthLink BC information: Preventing Falls: Exercises for Strength and Balance Johns Hopkins Medicine article: Fall Prevention: Balance and Strength Exercises for Older Adults
• Educate staff on fall prevention
  Centre for Effective Practice Falls Prevention Supplement for Care Staff
  Ontario Centres for Learning, Research and Innovation in Long-Term Care: Preventing Falls in Long-Term Care eLearning course information
  How to Safely Transfer Out/In Bed video
  Proper Positioning for Sitting video
• Ensure that all staff are trained in the proper use of fall prevention devices and know how to respond quickly to alerts
• Educate residents and their family members on fall reduction strategies
  
• Train staff to implement recommendations from best practice guidelines
  RNAO Best Practice Guidelines: Preventing Falls and Reducing Injury from Falls
• Participate in a community of practice with others who inform, share ideas, and support each other in improving the implementation of evidence-informed fall prevention practices
  Loop Fall Prevention Community of Practice