Falls and older people: preventative interventions

Falls among older people are a major public health challenge, because the sequelae of falls can be severe, both in terms of mental and physical health repercussions. Building on an earlier article that discussed the reasons why older people fall, this article describes the interventions that may help reduce falls among older people. Four interventions which could be applied within UK community settings, namely, the Otago programme, the falls management exercise programme, tai chi and home assessment and modification are outlined here. District nurses are well placed to contribute to a reduction in falls among older people by identifying those susceptible to fall risks among their clients and putting in place the necessary interventions to minimise them.

62 Are Junior Doctors aware about Risks of Falls in the Hospital

Introduction Falls are a leading cause of hospital acquired injuries. Junior doctors play a role as part of the multidisciplinary team, to prevent in-hospital falls and reduce harm following a fall. This study is to determine junior doctors’ level of knowledge regarding in-hospital falls. Methods A self-constructed and validated questionnaire was delivered to junior doctors during their weekly teaching session in the first 2weeks of May2019. It comprised of 1) Demography of participants 2) In- hospital falls prevention 3) In-hospital falls management. Correct responses from junior doctors working less than 1year and those more than 1year were compared. Results 46% of the junior doctors responded to the questionnaire. Only 9.5% (n=23) had exposure to a course on management of falls. 82% of them (n=218) were not aware of Malaysia National Falls Guideline, whilst only a quarter of the responders (n=67) heard about the presence of Fall Intervention Team. Less than 50% junior doctors were aware of the use of Morse Fall Scale as a standardised risk assessment tool. More than 50% of the correct responses are from more experienced junior doctors. 63.4% answered “Depression is a risk factor for falls” correctly, which represented the lowest of all the items. The second lowest item was “lines/catheters is a risk factor for falls”. The item which had the highest percentage of correct answers was “dizziness/vertigo is a risk factor for falls”, accounting for 260 subjects (98%). 56% of housemen considered physical restraints as part of fall intervention in hospital. Conclusion The more experienced junior doctors had better knowledge about falls in the hospital, however from this study it is shown that it is still lacking. Continuing medical education should be an avenue where in-hospital falls is emphasized, and their knowledge is regularly updated.