The following resource is designed to assist Long-Term Care (LTC) homes with the implementation of the Prevention of Falls and Fall Injuries in the Older Adult Best Practice Guideline. Documents found in this resource are evidence-based, but it is not a program plan. Each LTC home is unique and each home is in various stages of guideline implementation. LTC homes are advised to use the resource at their discretion. For those resources that have copyright notations, it is recommended that LTC homes obtain permission from the primary author prior to implementing them within their setting. The Toolkit is a dynamic resource, and is being updated and revised on a regular basis by the LTC Best Practices Initiative team. Visit this site often to see what's new!
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Berg Balance Scale
This scale rates a resident’s balance, and in turn, can be used to help determine resident fall risk. Available at http://www.fallpreventiontaskforce.org/pdf/BergBalanceScale.pdf.
MOHLTC Critical Incident
This form is mandatory for falls resulting in significant injury. It would be best to incorporate this form into policy and procedure.
Morse Falls Scale
This scale requires systematic, reliable assessment of a client’s fall risk factors upon admission, after a fall, with a change in status, and at discharge or transfer to a new setting. Available: The National Center for Patient Safety (NCPS). Author: Morse, J. M., Morse, R., & Tylko, S. (1989)
Post Fall Investigation
The incident reporting forms help determine who fell and why, and looking at these factors help discover how to prevent falls.
Tinetti Balance and Gait Evaluation Tool
These tools can be found and a tutorial is available at http://geriatrics.uthscsa.edu/tools/TINETTI.pdf.
Implementation Strategies for Prevention of Falls and Fall Injuries in the older adult
These implementation strategies are found in the best practice guideline on the prevention of falls and fall injuries in the older adult.
OANHSS Fall Prevention and Management Program - Policy, Procedures and Training Package
This document contains sample program objectives, policy, procedures and staff training materials and tools that meet the minimum requirements of the LTCHA and regulation. Obtained with permission. Source: Ontario Association of Non-Profit Homes and Services for Seniors (OANHSS). Release Date: November 19, 2010. Revised: March 31, 2011. Web: http://www.oanhss.org.
OANHSS Minimizing Restraining of Residents and the Use of Personal Assistance Service Devices (PASDs) - Policy, Procedures and Training Package
This document contains sample program objectives, policy, procedures and staff training materials and tools that meet the minimum requirements of the LTCHA and regulation. Obtained with permission. Source: Ontario Association of Non-Profit Homes and Services for Seniors (OANHSS). Release Date: December 3, 2010. Web: http://www.oanhss.org.
Policy and Procedure Falls Prevention and Management
Samples of Policies and Procedures that can be adapted to your home. Released: September 2006.
Mississauga Halton Falls Prevention Project: Long Term Care Falls Assessment Algorithm (pg. 45)
Attributed to a falls prevention program from Queensland Australia. The algorithm on page 45 is a decision tree for fall risk assessment on admission and after falls occur.
|Self Learning and PowerPoint Presentations|
RNAO's Falls Prevention: Building the Foundation for Safety
A self learning package for health care workers on identifying and modifying falls risk.
Falls Prevention and Management PowerPoint presentation
Slides to educate staff on falls risk and prevention. Prepared by Hazelynn Kinney, previous LTC Best Practice Coordinator, Central East Region. Based on the Toronto Best Practice Implementation Steering Committee’s Policy and Procedure ‘Falls Prevention and Management’ (2006).
Falls and Stroke
Slides addressing stroke and falls risk developed by the Central South Stroke Strategy.
|Fact Sheets / Pamphlets / Pocket Cards / Logos|
RNAO Fact Sheet – Reduce Your Risks for Falls
Highlights strategies for reducing fall risks. It is aimed at residents and families with recommendations for action based on the falls prevention guideline.
RNAO Réduire les risques de chute
RNAO Fiche de renseignements pour la sensibilisation en matière de santé.
RNAO Falls Pocket Card
This is a pocket card developed by RNAO based on the RNAO Falls Prevention BPG.
RNAO: BPGs to the Bedside – Action for Personal Support Workers
A series of fact sheets to increase Personal Support Worker’s (PSW) knowledge of how they can prevent resident falls.
The Bones Issue BP Blogger Newsletter January 2008
Educational DVD on Osteoporosis and Fracture Prevention in Long-Term Care
This is a 10-minute DVD linking osteoporosis and falls prevention. The Osteoporosis strategy will be distributing a free copy of this DVD to each of Ontario’s LTC homes in the winter of 2009. If you wish to order an additional copy contact the Osteoporosis strategy at: http://www.osteostrategy.on.ca/multimedia/Purchase%20Order%20Form%20Osteoporosis%20LTC%20online.
Falls in Long Term Care
Includes links to information on falls assessment, management, and restraints.
New South Wales Falls Prevention Network (Australia)
This website provides an Australian perspective on falls prevention.
Prevention of Falls Network Europe (ProFaNE)
This website provides a European perspective on falls prevention.
Canadian Falls Prevention Curriculum© (CFPC) - Summary
The Canadian Falls Prevention Curriculum© (CFPC) is designed to build on existing knowledge and skills of health professionals and community leaders working in the area of falls prevention among older adults (those 65 and over). The CFPC was developed under the leadership of Dr. Vicky Scott, Senior Advisor on Fall and Injury Prevention for the British Columbia Health Authorities and a team of experts in fall prevention from across Canada.
Universities/Colleges: Canadian Falls Prevention Curriculum© (CFPC) - E-Learning Course
University of Victoria, BC. HPPD215 2009F D01
Hamilton Self Assessment Test
Found in: Hamilton Health Sciences (2008). Best Practice for Prevention of Falls.
Assistive Devices Program (ADP)
For resident purchase of devices such as walkers; talk to the physiotherapist in your home.
Falls Risk Factor Identification from the World Health Organization
A study about fall risk factors and interventions for falls. Todd C, Skelton D (2004). What are the main risk factors for falls among older people and what are the most effective interventions to prevent these falls? Copenhagen, WHO Regional Office for Europe (Health Evidence Network report; http://www.euro.who.int/document/E82552.pdf, accessed February 2009).
Restraints (a column from the Nursing Issues section of the RNAO website)
An Advanced Practice Nurse in Ottawa responds to a student nurse’s question about understanding the appropriate use of restraints. Written from an Ontario perspective it contains reference to documents to help support practitioners use of the CNO guidelines and the Restraint Minimization Act.
Set me Free: Towards Reducing The Use of Physical Restraints
A resource for service providers on reducing restraint use in the health care setting. Order form resource only.
Falls Assessment Tools
This site provides a critique of tools and associated costs. The actual tool is not included in this website. To locate the desired tool, an internet search is recommended.
Hip Protectors – study
This is a National Health Service study from England which looks at the use and selection of Hip protectors.
Mississauga Halton LHIN report on Falls Prevention
This is a comprehensive falls prevention resource guide outlining everything you need to start a falls prevention program at your home.
Stepping In: Long-Term Care Collaborative Falls Prevention Project
This is a falls project summary report from Victoria, BC. It describes the need for a falls reporting form and prevention protocols. Appendix A outlines environmental initiatives, target residents & personnel and costs from the environmental changes related to the project.
Systematic Review of Mobility Assessment Tools
A published report compiled by the British Columbia Injury Research and Prevention Unit looking at assessment tools across different settings including LTC. http://www.injuryresearch.bc.ca/categorypages.aspx?catid=1&subcatid=7&catname=Injury%20Topics&subcatname=Falls%20Prevention Reference: Scott, V., Votova, K., Scanlan, A., Close, J. (2007).