Reducing falls in long-term care: A systematic review of the evidence

Background Seniors in long-term care (LTC) are particularly prone to falling due to illnesses and progressive physical and/or cognitive decline. Methods Searches were performed in MEDLINE, CINAHL, Ageline, Cochrane, and DARE from the databases' starting date to May 2003 using database-specific key words related to falls and nursing homes. Relevant trials published up to May 2006 were also included. The authors reviewed randomized controlled trials that met the established inclusion criteria and rated them for quality using the methodology of the Canadian Task Force on Preventive Health Care. Results Ten randomized controlled trials met inclusion criteria; all were rated as having fair quality. The research evidence addressed three main dimensions of concern: the screening or assessment process used to identify those at risk, the residents targeted to receive the intervention, and the spectrum of risk factors addressed by the intervention. Conclusion All residents of LTC facilities should be considered to be at increased risk for falling. Programs combining institution-wide precautions with multifactorial and individually tailored preventions have proven successful in reducing falls and injuries in LTC.