[insert Hospital Health Service banner here]
Non-departmental policy:
developed to assist HHS in meeting National Safety and Quality Standards
MFP 2013
Preventing Falls and Harm from Falls Policy
Policy Statement
The prevention and management of falls across the health care continuum reduces harm,
and minimises the severity of harm, resulting from falls for all people who are at risk of
falling. However, those most at risk are aged 65 years and over, or 50 years and over
among Indigenous Australians.
Intent of this Policy
To reduce the incidence of falls, and the harm resulting from falls, for people at risk of
falling through the implementation of:

a falls prevention and harm minimisation plan

standardised screening, assessment of risk factors, and management of
identified risk factors using tailored interventions

regular monitoring, investigation and reporting of falls

education with staff, patients and carers on the prevention of falls

local procedures for discharge planning in relation to falls

the above systems, interventions and processes to meet the National Safety and
Quality Health Service Standards, Standard 10 Preventing Falls and Harm from
Falls.
Scope
This policy applies to:

all xxx Hospital and Health Service employees (permanent, temporary and
casual) and all organisations and individuals acting as its agents (including
Visiting Medical Officers and other partners, contractors, consultants and
volunteers)

all settings across the health continuum including community, primary, acute,
rehabilitation and residential care health services with xxx Hospital and Health
Service.
Version No.: 1.0; Effective From: 18/09/2012
Page 1 of 8
Printed copies are uncontrolled
Queensland Health: Preventing Falls and Harm from
Falls Policy
Principles

All people are at risk of falls

Taking a consumer-centric approach including family and/or carers.

Providing a seamless high quality care experience across the health
continuum

Addressing identified and modifiable falls risk factor/s

Delivering falls prevention with a positive healthy active ageing focus using
Stay On Your Feet®

Working collaboratively in partnership with a range of stakeholders

Ensuring interdisciplinary involvement as all have a role to play

Implementing proven intervention/s
Legislative or other Authority

Aged Care Act 1997

Health Services Act 1991

Hospital and Health Boards Act 2011

Public Service Act 2008

Therapeutic Goods Act 1989

Trade Marks Act 1995

Work Health and Safety Act 2011
Related Policy or Documents

Australian Commission on Safety and Quality in Healthcare National Safety and
Quality in Healthcare Service Standards 2011

Australian Commission on Safety and Quality in Healthcare Preventing Falls and
Harm from Falls in Older People - Best Practice Guidelines for Australian
Hospitals 2009

Australian Commission on Safety and Quality in Healthcare Preventing Falls and
Harm from Falls in Older People - Best Practice Guidelines for Residential Aged
Care 2009
Version No.: 1.0; Effective From: 18/09/2012
Page 2 of 8
Printed copies are uncontrolled
Queensland Health: Preventing Falls and Harm from
Falls Policy

Australian Commission on Safety and Quality in Healthcare Preventing Falls and
Harm from Falls in Older People - Best Practice Guidelines for Community Care
2009

National Falls Prevention For Older People Plan: 2004 Onwards

Queensland Trauma Plan 2006

Queensland Health Strategic Plan 2012-2016

Queensland Health Patient Safety and Quality Plan 2008-2012

Queensland State-wide Health Services Plan 2007-2012

Positively Ageless Strategy – Queensland Seniors Strategy 2010-2020

Queensland Health Occupational Health and Safety Policy (QH-POL-275:2007)

Manual Tasks Involving the Handling of People Code of Practice 2001

Plant Code of Practice 2005

Queensland Health Clinical Governance Policy (QH-POL-007:2011)

Queensland Health Clinical Incidence Management Policy including Root Cause
Analysis and Open Disclosure (QH-POL-012:2012)
Supporting Documents

Implementation Standard for Preventing Falls and Harm from Falls

Hospital Falls Assessment and Management Plan

Residential Care Falls Assessment and Management Plan

Community Falls Assessment and Management Plan

Hospital Post Fall Clinical Pathway

Residential Care Post Fall Clinical Pathway

Adult Closed Head Injury Clinical Pathway for Emergency Departments

Stay On Your Feet® Long Checklist

Stay On Your Feet® In-patient Brochure

Stay On Your Feet® Community Good Practice Guidelines

Ageing with Vitality: Your everyday guide to healthy active living

Ageing with Vitality: Workbook
Version No.: 1.0; Effective From: 18/09/2012
Page 3 of 8
Printed copies are uncontrolled
Queensland Health: Preventing Falls and Harm from
Falls Policy
Review
This policy will be reviewed at least every three years.
Date of last review: 11/09/2102
Supersedes:
not applicable
Approval and Implementation
Policy Custodian
xxx Hospital and Health Service
Responsible xxx Health and Hospital Service Executive:
Approving Officer:
Approval date:
xxx
Effective from:
xxx
Definitions of terms used in this policy and supporting documents
Term
Definition / Explanation / Details
Source
Health care team
All staff involved in the provision of health care
including
frontline
clinicians,
management,
administration, operational and porterage staff. All
staff have a role to play in preventing falls in older
people.
Australian Commission on
Safety and Quality in
Healthcare Preventing Falls
and Harm from Falls in Older
People - Best Practice
Guidelines for Australian
Hospitals 2009
Older adults
Falls can occur at all ages, but the frequency and
severity of falls-related injury increases with age
(2). Older adults are defined as those aged 65
years and over.
Australian Commission on
Safety
and
Quality
in
Healthcare Preventing Falls
and Harm from Falls in Older
People
Best
Practice
Guidelines
for
Australian
Hospitals 2009
When considering Indigenous Australians, older
people commonly refers to people aged over 50
years (3).
Fall
A fall is an event that results in a person coming to
rest inadvertently on the ground or floor or other
lower level.
Version No.: 1.0; Effective From: 18/09/2012
World Health Organization.
Definition
of
a
fall.
http://www.who.int/violence
_injury_prevention/other_injury
Page 4 of 8
Printed copies are uncontrolled
Queensland Health: Preventing Falls and Harm from
Falls Policy
Term
Definition / Explanation / Details
To allow a consistent approach to falls prevention
in Queensland and comparisons at a national and
international level, it is important a standard
definition for falls is used in all settings (1, 2).
Source
/falls/links/en/index.html
Injurious fall
The Prevention of Falls Network Europe definition
of an injurious falls is one that results in peripheral
fractures defined as any fracture of the limb girdles
or of the limbs. Other definitions of an injurious fall
include traumatic brain injury.
Rushworth N (2009). Brain
Injury Australia Policy Paper:
Falls-Related Traumatic Brain
Injury. http://www.bia.net.au/
Reports_factsheets/BIA%20
Paper_Falls%20TBI.pdf
Harm
‘Harm’ can range from a small skin tear all the way
through to loss of life or limb. The severity of harm
caused in health care is designated by using the
Severity Assessment Code (SAC) classification
system which provides a way to distinguish the
severity of events. Ratings are based on the
consequences to the patient of the adverse event
and range from levels one to three.
Patient Safety: From Learning
to Action IV
Fourth Queensland Health
Report on Clinical Incidents
and Sentinel Events in the
Queensland Public Health
System 2008/09
January 2011 pp 15, 20
Screening
A brief process estimating a person’s risk of falling
classifying people at either low or increased risk.
Falls risk screening usually only involves reviewing
a few key items and can be used to identify patient
who require a high level of supervision and more
detailed falls risk assessment.
Australian Commission on
Safety and Quality in
Healthcare Preventing Falls
and Harm from Falls in Older
People - Best Practice
Guidelines for Australian
Hospitals 2009 p30
Assessment
Falls risk assessments aim to identify factors that
increase falls risks. This assessment is a more
detailed process than screening and is used to
identify underlying falls risk factors for tailored
intervention/action.
Australian Commission on
Safety and Quality in
Healthcare Preventing Falls
and Harm from Falls in Older
People - Best Practice
Guidelines for Australian
Hospitals 2009 pp 30-31
Risk factors
There are a number of risk factors among older
people. A person’s risk of falling increases both
with age and with the number of risk factors. Risk
factors may be divided into intrinsic and extrinsic
risk factors.
Australian Commission on
Safety
and
Quality
in
Healthcare Preventing Falls
and Harm from Falls in Older
People
Best
Practice
Guidelines
for
Australian
Hospitals 2009
Intrinsic risk factors: relate to a person’s behaviour
or condition i.e. previous fall, postural instability,
muscle weakness
Extrinsic risk factors: relate to a person’s
environment or their interaction with the
environment i.e. time of day, bedside environment
Tailored
interventions
and/or actions
An intervention is an evidence based therapeutic
procedure or treatment strategy designed to cure,
alleviate or improve a certain condition.
Version No.: 1.0; Effective From: 18/09/2012
Australian Commission on
Safety
and
Quality
in
Healthcare Preventing Falls
Page 5 of 8
Printed copies are uncontrolled
Queensland Health: Preventing Falls and Harm from
Falls Policy
Term
Definition / Explanation / Details
Interventions can be in the form of medication,
surgery, early detection (screening), dietary
supplements, education or minimisation of risk
factors.
Source
and Harm from Falls in Older
People
Best
Practice
Guidelines
for
Australian
Hospitals 2009
Managing many of the risk factors from falls i.e.
Delirium or balance problems will have wider
benefits beyond falls prevention. Best practice in
fall and injury prevention includes implementing
standard falls prevention strategies, identifying fall
risk and implementing targeted individualised
strategies that are resourced adequately, and
monitored and reviewed regularly.
Interventions that address several falls risk factors
at the same time are known as multi-factorial, for
example: health related issues such as physical
activity, balance and vision and environmental
hazards.
Multi-factorial strategies have been shown to be
highly effective in reducing falls among communitydwelling older persons when they are based upon
the results of risk factor assessment (3, 4, 5, 6, 7,
8). The successful strategies include:
 environmental risk assessment and
modification
Falls prevention
balance and gait training with appropriate
use of assistive devices

medication review and modification

managing visual concerns

addressing orthostatic hypotension and
other cardiovascular problems

physical activity (strength and balance),
this has been shown to be a particularly
important component of a multi-factorial
intervention.
Falls prevention is:
 preventing and minimising the risk of tripping,
slipping, stumbling and then falling, by
identifying what causes falls and what can
protect people from falling
 identifying how to minimise the physical and
psychological effects that results from falling

Falls injury prevention

The basis of falls prevention is ‘prevention is
better than cure’. Many falls can be prevented.
Falls prevention also includes falls injury
prevention:
 reducing the number of people injured from
Version No.: 1.0; Effective From: 18/09/2012
Australian Commission on
Safety
and
Quality
in
Healthcare Preventing Falls
and Harm from Falls in Older
People
Best
Practice
Guidelines
for
Australian
Hospitals 2009
Australian Commission
Safety
and
Quality
on
in
Page 6 of 8
Printed copies are uncontrolled
Queensland Health: Preventing Falls and Harm from
Falls Policy
Term
Healthy active ageing
Definition / Explanation / Details
falling

preventing and reducing the seriousness of
injuries that can result from falling

identifying the best way to help an injured
person recover (sometimes known as
rehabilitation)
Source
Healthcare Preventing Falls
and Harm from Falls in Older
People
Best
Practice
Guidelines
for
Australian
Hospitals 2009
Healthy active ageing is a positive term used to
talk about action taken by older people to prevent
falls and improve their overall health. The term
‘healthy active ageing’ is used because:

the loss of muscle strength and balance from
inactivity is a major cause of falls

the term is positive and helps to remove the
stereotype of frailty and being a burden on
society

by encouraging and supporting older people to
stay active every day, it helps to focus
attention on one of the major components of
falls prevention

there are broader health benefits from being
healthy and active including improved heart
health, reduced risk of cancer and depression.
References
1. Safety and Quality Council. 2005. Implementation guide for preventing falls and harm from falls in
older people. Best practice guidelines for Australian hospitals and residential aged care facilities.
Commonwealth of Australia, Canberra.
2. Todd, C., Ballinger, C. & Whitehead, S. 2007. Reviews of socio-demographic factors related to falls
and environmental interventions to prevent falls amongst older people living in the community. World
Health Organisation.
3. Yoshida, S. August 2007. A Global Report on Falls Prevention – Epidemiology of Falls. World Health
Organisation.
4. Lord, S. R., Sherrington, C., Menz, H. & Close, J. 2007. Falls in older people: risk factors and
strategies for prevention. 2nd Edition. Cambridge University Press.
5. 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). Accessed 20/8/2007.
6. McClure, R., Turner, C., Peel, N., Spinks, A., Eakin, E. & Hughes, K. Population-based interventions
for the prevention of fall related injuries in older people (Review). Cochrane Database of Systematic
Reviews 2005, Issue. Art.No.:CD004441.DOI:10.1002/14651858.CS004441.pub2.
Version No.: 1.0; Effective From: 18/09/2012
Page 7 of 8
Printed copies are uncontrolled
Queensland Health: Preventing Falls and Harm from
Falls Policy
7. Scott, V. 3 April 2007. World Health Organisation Report: Prevention of Falls in Older Age.
Background Paper: Falls Prevention: Policy, Research and Practice. World Health Organisation Report.
8. Gillespie, L. D., Gillespie, W. J., Robertson, M. C., Lamb, S. E., Cummings, R. G. & Rowe, B. H.
Interventions for preventing falls in elderly people. Cochrane Database of Systematic Reviews 2003,
Issue 4. Art.No.:CD000340.DOU:10.1002/14651858.CD000340.
Version No.: 1.0; Effective From: 18/09/2012
Page 8 of 8
Printed copies are uncontrolled