Geriatric falls presenting to the emergency department (ED) are rising due to our rapidly ageing population. As part of a group of geriatric-focused emergency medicine practitioners, we describe a multidisciplinary falls prevention tool using the acronym.
Accidental Falls/prevention & control* ; Aged ; Emergency Service, Hospital ; Geriatric Assessment ; Humans

BACKGROUND: Falls are common in older people and a leading cause of injury. Exercise programmes are available for falls prevention, including the Otago Exercise Programme (OEP). The Southeast Asia region has a rapidly ageing population with unique aspects to consider in falls prevention. This systematic review aims to explore the effectiveness of OEP in Southeast Asia for falls prevention. METHODS: A literature search conducted in April 2020 of PubMed and Google Scholar databases was performed to identify randomised controlled trials on OEP in Southeast Asia. RESULTS: Three studies met inclusion criteria for the systematic review. The studies in Malaysia and Thailand did not identify any differences in the rate of falls with the modified OEP intervention compared to conventional treatment. The study from Indonesia inferred a reduced fall risk with improved Timed Up and Go with the intervention, but did not quantify fall rates. CONCLUSION: The three studies identified used a modified OEP, with limited evidence of efficacy or reduction in fall rates. Further research is required, particularly randomized controlled trials to evaluate OEP for falls prevention in Southeast Asia.
Accidental Falls ; Secondary Prevention ; Asia, Southeastern

PURPOSE: The purpose of this study was to build a model to predict the fall prevention behavior of nurses in small and medium sized hospitals. METHODS: Participants were 382 nurses from 13 hospitals who responded to the structured self-reported questionnaire. The research model was based on previous study of fall prevention, theory of planned behavior, and the health belief model. RESULTS: The modified model generally showed higher levels than recommended level of model fit indices and acceptable explanation. Of 17 hypothetical paths, 14 were supported. Predicting variables explained 51.6% of fall prevention behavior. The fall prevention behavior of nurses showed a direct influence of fall prevention expectations, fall prevent threats, perceived behavioral control for fall prevention, and intention to prevent falls and an indirect of influence of patient safety culture, attitude toward fall prevention, and the subjective norm. CONCLUSION: Findings show a need to identify a range of barrier factors to increase the benefits of fall prevention behavior and enhance the perceived control of fall prevention so that nurses will be able to promote fall prevention behavior in hospitals. Also, it is critical to increase awareness of patient safety culture among nurses.
Accident Prevention ; Accidental Falls ; Health Behavior ; Humans ; Intention ; Nurses* ; Patient Safety ; Safety Management

OBJECTIVE: The injury-related disease burden in South Korea is relatively high compared to that in other nations. This study was conducted to identify the scale and causes of injury by severity, using an injury pyramid and analyzing the sex and age-dependent differences and the basic demographic characteristics. METHODS: Unintentional injury was estimated for each group after classifying injury-related deaths, hospitalizations, and outpatient department (OPD) visits based on their severity. The injury pyramid was calculated by classifying the injury outcomes into deaths, hospitalizations, and outpatient visits. RESULTS: The incidence of unintentional injury included 31.74 deaths, 1,715.27 hospitalizations, and 7,317.55 OPD visits per 100,000 persons. The incidence of injury was higher among males than that among females. There were more hospitalizations and OPD visits than deaths among females. The mortality and hospitalization rates due to injury per 100,000 persons were the highest among those ≥75 years old, and the OPD visit rate was the highest among preschool children aged 0 to 6 years. The injury mechanisms that caused most deaths and hospitalizations in South Korea were injuries related to traffic, falls, poisoning, and burns/fires. CONCLUSION: The scale of unintentional injury varies based on sex, age, and injury mechanism; additionally there are differences in the incidence of injuries between males and females depending on their age and injury mechanism. The high incidence of injury in elderly people could be a factor that increases the burden of injury in South Korea; hence, it is necessary to develop an injury prevention program that targets the elderly.
Accident Prevention ; Accidental Falls ; Aged ; Child, Preschool ; Epidemiology ; Female ; Hospitalization ; Humans ; Incidence ; Korea* ; Male ; Mortality ; Outpatients ; Poisoning

OBJECTIVES: To investigate establishing, applying and evaluating the fall prevention and control information system in elderly community. METHODS: Relying on internet technology and informatization means, the fall comprehensive prevention and control strategy of elderly was guided into online from offline. The fall prevention and control information system which was a collection of risk assessment, remote education and feedback was established. One hundred and twenty-six elderly (over 60 years old) in community were screened in this study and 84 high-risk elders who were involved in the remote continuous comprehensive intervention were screened out. Intervening measures included distributing propaganda album, making mission slides and video used to play with the interpretation remotely. Then fall related situation before and after intervention was analyzed and the effectiveness of system evaluated. RESULTS: After remote intervention, the fall incidence of high-risk group decreased from 21.43% to 4.76%(<0.01). The body balance and gait stability improved clearly(<0. 01). The rate of taking proper prevention and control behavior significantly improved(<0.01). They believed in themselves not to fall down with more confidence when taking complex behaviors(<0.01). The security of environment at home significantly enhanced(<0. 01). CONCLUSIONS Fall prevention and control information system in elderly community was innovative and convenient. The system could roundly assess the status related to fall and accurately screen out high-risk group. The system could implement the remote continuous comprehensive intervention so that the incident of fall was decrease. In conclusion, the system is stable and effective, can be further popularization and application as a successful pilot.
Accidental Falls ; prevention & control ; Aged ; Health Information Systems ; Humans ; Incidence ; Middle Aged

PURPOSE: This study aims to identify the effect of pediatric fall prevention education with leaflets and picture books on the fall-related knowledge and preventive behaviors in caregivers of inpatient children. METHODS: This study is a non-equivalent control group non-synchronized design. It divided 62 caregivers of inpatient children aged 5 and under into an experimental group and a control group in P general hospital located in B City. RESULTS: Fall related knowledge score in the experimental group was increased by 2 points after the intervention and the score in the comparison group was increased by 0.1 points. The difference after the intervention in fall related knowledge scores between the two groups was statistically significant (t=7.67, p<.001). The fall related prevention behavior score of the experimental group increased by 9.3 points after the intervention, and the score of the comparison group increased by 2.5 points. The difference in the scores of fall related prevention behaviors between the two groups was statistically significant (t=5.71, p<.001). CONCLUSION: Pediatric inpatient fall prevention education using leaflets and picture books can improve caregivers' fall-related knowledge and preventive behaviors. In turn, this can reduce children's falls in pediatric wards in general hospitals.
Accident Prevention ; Accidental Falls ; Caregivers ; Child ; Education* ; Hospitals, General ; Humans ; Inpatients* ; Pediatrics

BACKGROUND AND OBJECTIVES: A fall refers to a sudden fall accident resulting in injury and hurt of the human body. In the hospital, fall accidents occur mainly in dizzy patients or elderly people, but can also occur even in young people who fail to adapt to the unfamiliar hospital environment. This study analyzed the incidence of fall accidents and its pattern in dizzy patients in a tertiary hospital in South Korea. SUBJECTS AND METHOD: This study was conducted using 477 fall accidents that occurred in a tertiary hospital in Korea from 2011 to 2015. Extensively investigated were related fall risk factors such as patient's sex, age, medical department, diagnosis, first witness, mental status, physical activity, patient risk factors, walking aids, medication use and treatment. RESULTS: Dizziness induced falls consisted of 20.5% of the total fall accidents. Sedative medications were frequently used in patients of dizziness induced falls (42.9%). Fall acidents were mainly detected by nurses 33%. The frequente sites of fall were the bed rooms (55%), the corridor (15%) or the bath rooms (8%). Types of physical damage were no damage (47%), abrasion or bruising (20%), laceration (10%), bath rooms (8%), fracture (3%), and head trauma (1%). In 532 treatments, observation was recommended for 68%, sterilization 15.2%, suture 4.7%, cast 1%, and surgery 1%. CONCLUSION: The study finds that the fall risk screening test and Multifactorial Fall Prevention Program should be performed for all high-risk patients of fall. About 20% of falls were associated with otologic dizziness, and otolaryngology doctors should pay attention to the fall problem and the medication related to dizziness, which may potentially increase the risk of falls.
Accident Prevention ; Accidental Falls ; Aged ; Baths ; Craniocerebral Trauma ; Diagnosis ; Dizziness ; Education ; Human Body ; Humans ; Incidence ; Korea* ; Lacerations ; Mass Screening ; Methods ; Motor Activity ; Otolaryngology ; Risk Factors ; Sterilization ; Sutures ; Tertiary Care Centers* ; Walking

INTRODUCTIONThe prevalence of orthostatic hypotension (OH) among the elderly population in Singapore, as defined by a decline in blood pressure upon a change in position, is not well-established. Studies associate OH with clinically significant outcomes such as falls. This study aims to determine the prevalence of OH among elderly patients attending a public primary care clinic (polyclinic) for chronic disease management, and examine the relationships between postulated risk factors and OH.

METHODSPatients aged ≥ 65 years attending a typical polyclinic in Geylang were identified and targeted for recruitment at the study site. A questionnaire on symptoms and postulated risk factors was administered, followed by supine and standing blood pressure measurements. Cross-sectional analysis was performed with independent sample t-test for continuous data and chi-square test for categorical data. Prevalence rate ratios with 95% confidence interval were calculated for the latter.

RESULTSA total of 364 multiethnic patients participated in the study. The prevalence of OH was 11.0%. Older age, comorbidities such as cardiac failure and kidney disease, being physically inactive at work, fatigue, self-reported dizziness in the past year, and the use of loop diuretics were found to be significantly associated with OH.

CONCLUSIONAbout one in ten elderly patients at a local polyclinic was affected by OH, which was associated with multiple factors. Some of these factors are modifiable and can be addressed to reduce the incidence of OH.

Accidental Falls ; prevention & control ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Blood Pressure ; Blood Pressure Determination ; Cross-Sectional Studies ; Female ; Geriatrics ; Humans ; Hypotension, Orthostatic ; diagnosis ; epidemiology ; therapy ; Male ; Middle Aged ; Models, Statistical ; Prevalence ; Primary Health Care ; Risk Factors ; Singapore

BACKGROUND: Household waste collectors (HWCs) are exposed to hazardous conditions. This study investigates the patterns of workplace injuries and work-related illnesses of HWCs. METHODS: This study uses cases of workplace injuries and work-related illnesses of HWCs that occurred between 2010 and 2011. We analyzed 325 cases of injuries and 36 cases of illnesses according to the workers' age, length of employment, size of workplace, injured part of body, day and month of injury, type of accident, agency of accident, and collection process. RESULTS: There were significant differences in the effect of workers' length of employment, injured part of body, type of accident, agency of accident, and collection process. Results show that most injuries occur in workers in their 50s and older. This study also shows that 51.4% of injuries occur at businesses with 49 employees or fewer. Injuries to waste collectors happen most often when workers are electrocuted after slipping on the ground. The second most prevalent form of injury is falling, which usually happens when workers hang from the rear of the truck during transportation or otherwise slip and fall from the truck. Work-related illnesses amongst waste collectors are mostly musculoskeletal conditions due to damaging postures. CONCLUSION: These findings will be instructive in devising policies and guidelines for preventing workplace injuries and work-related illnesses of HWCs.
Accident Prevention ; Accidental Falls ; Commerce ; Employment ; Family Characteristics* ; Motor Vehicles ; Posture ; Transportation

The Health Promotion Board (HPB) has developed the Clinical Practice Guidelines (CPG) on Falls Prevention among Older Adults Living in the Community to provide health professionals in Singapore with recommendations for evidence-based assessments and interventions for falls prevention. This article reproduces the introduction and executive summary of the key recommendations from the HPB-MOH CPG on Falls Prevention among Older Adults Living in the Community for the information of SMJ readers. The chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Health Promotion Board website: http://www.hpb.gov. sg/cpg-falls-prevention. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.
Accidental Falls ; prevention & control ; Aged ; Environment ; Evidence-Based Medicine ; Geriatrics ; standards ; Health Promotion ; methods ; Housing ; Humans ; Incidence ; Middle Aged ; Practice Guidelines as Topic ; Risk Assessment ; methods ; Singapore ; Social Class