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As part of the Trust’s clinical governance arrangements and to facilitate a systematic approach to clinical governance a risk assessment was conducted. This assessment identified that falls were a significant risk of patients, both during episodes of in‐patient care and in their own homes. There is little evidence nationally to guide good practice; therefore a multidispiplinary steering group was set up to develop a comprehensive approach to falls prevention. This resulted in the development of evidence based falls prediction tools, Trust policy and guidelines and extensive staff training programmes. Information leaflets have been provided to patients and additional services such as falls groups have been developed.

The purpose of this paper is to gain insight into nurses' understandings of what constitutes suitable footwear for older people in care homes.

An exploratory descriptive qualitative survey was carried out of 20 registered nurses employed in six Scottish care homes for older people. Data were collected using a semi-structured questionnaire that included five open-ended questions. Content analysis was used to theme footwear perceptions.

Participants had several views about what encompasses safe footwear; some were erroneous. The link between inappropriate footwear and falls was recognised by 80 per cent of respondents, but some were unclear about the features that effect or inhibit safety. No UK or international standardised guidelines were identified that advise nurses about appropriate footwear for older people.

It is unknown whether respondents represent the nurse population because findings are restricted by a small sample size. Nonetheless, the group showed variable understanding of what constitutes safe footwear for older people and links with fall prevention. Improved nurse-education about what comprises safe footwear and the links with falls prevention in older people is required. Structured guidelines to direct nurse educators about what to teach student nurses about appropriate footwear for older people may work towards reducing falls.

No guidelines to direct nurses about appropriate footwear for older people in care homes have been written. Key points have been developed.

Age-related processes are marked by physiological, psychological and social decline, threatening health, quality of life, functional status and the mobility of individuals. As the impact of demographic change also begins to affect persons with intellectual disabilities (ID), issues and needs regarding the aging process are slowly entering the field of ID research. The paper aims to discuss these issues.

In the population of older people with ID, important, age-related events such as falls have prompted increasing research. Falls may lead to several negative health outcomes, require that an individual receives higher levels of care sometimes including hospitalisation and, in the worst case, hasten death. Falls also lead to psychological consequences such as fear of falling which fuels a vicious circle in which older persons afraid of falling reduce their physical activity, in turn hastening their functional decline.

Fall prevention in persons with ID is just evolving and further research is clearly necessary. This research can draw on the existing evidence from other fall prevention areas, especially the work carried out with the general older population.

As stated by Finlayson, a useful next step would be the development of a consensus on the definitions and methodology that should underpin future fall prevention research with persons with ID.

Background: The ageing population is generating increasing concern over the occurrence and associated costs of falls in healthcare settings. Supplementary to the investigation of strategies to prevent falls, is the consideration of ways to reduce the number of injuries resulting from falls in these settings.Aims: This overview assesses the status of research on flooring in healthcare settings to reduce the incidence of injury resulting from falls.Methods: A comprehensive literature search, carried out in conjunction with a Cochrane Systematic Review on hospital environments for patient health‐related outcomes, identified the available evidence. Searches were also conducted in Medline and Scopus specifically to identify studies on flooring types, falls, and injuries. Reference lists of relevant studies and reviews were scanned and relevant authors were approached for further information.Conclusions: Flooring should be considered as a possible intervention for reducing injuries from falls, however, more rigorous and higher quality research is needed to identify the most appropriate materials for use.

The purpose of this paper is to evaluate the impact of adopting the Six Sigma define, measure, analyze, improve and control (DMAIC) approach in reducing patients fall rate in an Academic Medical Center, Saudi Arabia.

A prospective study design was adopted and this study was conducted at King Fahd Hospital of the University (KFHU) during the year 2014. Based on the historical data of the patients’ falls reported at KFHU during the year 2013, the goal was fixed to reduce the falls rate from 7.18 to<3 (over 60 percent reduction) by the end of December 2014. This study was conducted through the five phases of “DMAIC” approach using various quality tools. Three time periods were identified, namely, pre-intervention phase; intervention phase; and post-intervention phase. Appropriate strategies were identified through the process of brainstorming and were implemented to study the potential causes leading to the occurrence of falls.

The pre-intervention falls rate was reported as 6.57 whereas the post-intervention falls rate was measured as 1.91 (demonstrating a 70.93 percent reduction) after the implementation of improvement strategies. The adherence rate toward the practice of carrying falls risk assessment and hourly rounding was observed to be high where 88 percent of nurses are regularly practicing it. A control plan was also executed to sustain the improvements obtained.

The Six Sigma “DMAIC” approach improves the processes related to the prevention of falls. A greater reduction in patients falls rate (over 70 percent) was observed after the implementation of the improvement strategy.

The purpose of this paper is to compare the ability of the Morse Fall Scale (MFS) and Farmer's fall-risk assessment tool (FFAT) to identify correlations between risk factors and falls among older adult long-term care (LTC) facility residents.

This was a correlational retrospective study. 200 medical records of older adults hospitalized in a LTC facility in central Israel, from January 2017 to January 2018, were examined.

Of all the residents, 75% and 99.5% of the residents were identified as having a high fall risk according to the MFS and FFAT, respectively. Only 12.5% of residents actually fell. MFS score was weakly correlated with actual falls (odds ratio = 1.035). It was also found that all fallers fell during their first week at the facility.

Future research should explore the ability of the tools to capture changes in the fall risk by repeat assessments, as this has not been examined in the present study.

The MFS and FFAT tool may have little value in assessing fall risk in older adult LTC facility residents. Therefore, nurses should perform a clinical evaluation of each individual patient. In addition, nurses should place a particular emphasis on fall risk and prevention during the first week following admission.

The findings of the present study raise doubts regarding the utility of the common practice of assessing fall risk in older adult LTC facility residents using the tools MFS and the FFAT, thus emphasizing the need to adopt a different approach.

Screening for fall risks is an important part of fall and fracture prevention. This study aims to investigate cross-sectional inter-instrumental agreement and participants’ preferences of the self-rated Falls Risk Questionnaire (FRQ) and Activities Specific Balance Confidence 6 items (ABC-6). This study also aimed to compare FRQ and ABC-6 scores in older adults with and without a history of falls.

Through an online and snowball sampling survey, 114 respondents were recruited from six countries. Respondents were asked to perform FRQ and ABC-6 surveys.

The mean respondent age was 67 years, and 44.8% reported falls in the past year. The mean of rescored FRQ and ABC-6 scores were 68.6% and 66.2%, respectively. The FRQ and ABC-6 scores for fallers were lower than non-fallers. Bland and Altman’s method indicated the mean −2.6 and two standard deviations 20.9 differences between ABC-6 and FRQ, which means an overall agreement between these tools. Most of the respondents, 36% had no preference between ABC-6 and FRQ, 34% preferred none, 21% preferred the ABC-6 and 9% preferred the FRQ for screening future falls risk.

Both ABC-6 and FRQ can distinguish between fallers and non-fallers, and findings of this study can be used to support the use of the FRQ for falls screening in older adults.

Balance is key to improving the quality of life for older patients. This article looks at barriers to participation, which exist in different forms in all areas of fitness and exercise, and are of an emotional or practical nature. The feature quotes a study published in The Gerontologist carried out by researchers at the University of Southampton's School of Psychology. They sought to identify factors that may inhibit uptake to falls‐related interventions. Dr Dawn Skelton discusses the importance of exercise to reduce the number of falls and fall‐related injuries in older people, and the BalanceMaster machine is highlighted.

This study assesses the prevalence of accidental falls in Thailand's older adult population and the contingent influences surrounding this prevalence.

Data were drawn from the Cross-Sectional National Surveys of Older Persons in Thailand, pooling of four survey datasets which took place in 2007, 2011, 2014 and 2017. Stratified two-stage sampling was employed. Interviews were conducted with sample sizes of 11,370, 11,061, 13,775 and 12,457 senior citizens, aged 60 and above, in the respective survey years. Further investigation was conducted on subjects who reported to be of good health and without any disability, yet experienced accidental falls. The prevalence of accidental falls was examined, and variable aspects concerning fall risk were assessed with probability-weighted multiple logistic regression.

The average prevalence of accidental falls from the four surveys was 4.7%. Significant risk factors identified were advanced age, being female, living in a rural residence, having worked in the previous 7 days, lack of/excessive exercise, alcohol consumption, smoking and having an outdoor lavatory.

Accidental falls tend to increase among community-dwelling seniors aged 60 and above. Falls increase with age and are more common among the women in that demographic. Findings suggest the need for government and local agencies to consider tailoring some public health approaches to the prevention of accidental falls. This study also highlights the necessity of proper work environment maintenance to prevent these falls.

This paper has three main elements to it. The first is to present some of the epidemiological considerations of this situation. The second is to describe some of the risk factors and by extension, the interventions that might be helpful. Third, a case study on the Welsh situation will be described.

This paper draws from the published literature and combines this with the professional experience of the author in Wales. Epidemiological calculations are presented using readily available data and summarised diagrammatically.

Falls and fractures constitute a significant public health challenge due to the number of individuals affected and the seriousness of impacts. Risk factors, such as vitamin D deficiency, are open to modification and interventions such as exercise are also helpful. In Wales, policy could be geared to improving the response to this, such as an expansion of cost saving fracture liaison services.

This paper draws together a diverse literature to help develop policy in Wales.