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 Program team. Visit this site often to see what's new!
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This article highlights the impact of implementing the RNAO Falls Best practice guideline.
| Laviolette, K. (2020). Purposeful hourly rounding in long-term-care. Canadian Nurses Association. https://www.canadian-nurse.com/en/articles/issues/2020/april-2020/purposeful-hourly-rounding-in-long-term-care |
Copyright ©, Canadian Nurses Association, 50 Driveway, Ottawa, Ontario, K2P 1E2 CANADA, 2018 all rights reserved
Example signage of Intentional Hourly Rounding Poster from Fraser Health, British Columbia, Canada.
| Registered Nurses’ Association of Ontario. (2017). Appendix K of RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.). Toronto, ON: Author. (p.115) |
This table lists common components of universal falls precautions that health care organizations can determine which precautions are applicable to their setting.
| Registered Nurses’ Association of Ontario. (2017). Appendix K of RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.). Toronto, ON: Author. (p.113) |
Example of a form for documentation from St Joseph’s Healthcare Hamilton on falls debriefing and action plan.
| Registered Nurses’ Association of Ontario. (2017). Appendix J: Example: Falls debriefing and action plan from St. Joseph's Healthcare Hamilton (Ontario, Canada) of RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.). Toronto, ON: Author. (p.111-112.) |
Table 20 is a description of resources available to support post fall assessments.
| Registered Nurses’ Association of Ontario. (2017). Appendix J of RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.). Toronto, ON: Author. (p.109-110) |
Table 19 provides a list of medication resources for use in fall prevention and reduction of injury from falls.
| Registered Nurses’ Association of Ontario. (2017). Appendix I of RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.). Toronto, ON: Author. (p.108.) |
Table 18 summarizes different approaches to exercise and physical training interventions with varying degrees of effectiveness.
| Registered Nurses’ Association of Ontario. (2017). Appendix H of RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.). Toronto, ON: Author. (p.104-107.) |
Table-14, 15, 16 and 17 summarize evidence from the reviewed literature on specific fall prevention and injury reduction interventions. They are organized according to the benefit of the interventions. Health-care providers use clinical judgment to determine if interventions apply to their settings.
| Registered Nurses’ Association of Ontario. (2017). Appendix G of RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.). Toronto, ON: Author. (p.98-103) |
Appendix F - provides a summary of related approaches and tools for assessing fall risk. The tools are categorized as follows: gait and balance; general fall risk and fear of falls. It is important for the organization to review the findings to support selection of tools for settings and population(s) served noting that other tools are available that address specific risk factors.
| Registered Nurses’ Association of Ontario. (2017). Appendix F of RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.). Toronto, ON: Author. (p.92-97) |
Tables 10, 11 and 12 list of risk factors that include fall risk factors, health conditions associated with increased risk of falls, and factors associated with increased risk of falls injury.
| Registered Nurses’ Association of Ontario. (2017). Appendix E of RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.). Toronto, ON: Author. (p.88-91.) |
