Ministry of Health Malaysia
MODULE NO.
FALLS IN THE HOSPITAL
THE MALAYSIAN PATIENT SAFETY GOAL 2.0
PARTICIPANTS NOTES
MODULE DEVELOPED BY : MODULE DEVELOPED BY :
SLIDE NO.
SLIDE NO.
NATIONAL FALL PREVENTION AND NATIONAL FALL PREVENTION AND
1
1
INTERVENTION STEERING COMMITTEE INTERVENTION STEERING COMMITTEE
MinistryMINISTRY OF HEALTH
of Health Malaysia MALAYSIA MINISTRY OF HEALTH MALAYSIA
MODULE DEVELOPED BY :
SLIDE NO.
NATIONAL FALL PREVENTION AND
2
INTERVENTION STEERING COMMITTEE
Ministry of Health Malaysia
MINISTRY OF HEALTH MALAYSIA
MALAYSIAN
PATIENT
SAFETY GOAL 2.0
MODULE DEVELOPED BY :
SLIDE NO.
NATIONAL FALL PREVENTION AND
3
INTERVENTION STEERING COMMITTEE
Ministry of Health Malaysia
MINISTRY OF HEALTH MALAYSIA
FALLS
Definition:
• Sudden
• Unintentional
• Change in position
• Coming to rest on the ground or other lower level
MODULE DEVELOPED BY :
SLIDE NO.
NATIONAL FALL PREVENTION AND
4
INTERVENTION STEERING COMMITTEE
Ministry of Health Malaysia
MINISTRY OF HEALTH MALAYSIA
FALLS STATISTICS
● Not all falls are preventable but neither are they inevitable
● 20– 30% of falls can be prevented by assessing risks
and intervening to reduce these risks1
Therefore – FALLS can be avoided
● 3-5 fall events per 1000 patient days
● 30% injury
● 1-3% severe injury eg. head trauma and fracture
1. Morris R, O'Riordan S. (2017) Prevention of falls in hospital. Clin Med, 360-362. doi: 10.7861/clinmedicine.17-4-360. PMID: 28765417; PMCID: PMC6297656.
2. Oliver D, Healey F, Haines TP. (2010) Preventing falls and fall-related injuries in hospitals. Clin Geriatr Med, 26(4):645-92. doi: 10.1016/[Link].2010.06.005. PMID: 20934615.
MODULE DEVELOPED BY :
SLIDE NO.
NATIONAL FALL PREVENTION AND
5
INTERVENTION STEERING COMMITTEE
Ministry of Health Malaysia
MINISTRY OF HEALTH MALAYSIA
RISK FACTORS OF FALLS
INTRINSIC FACTORS
EXTRINSIC FACTORS
BIOLOGICAL ENVIRONMENTAL
Advanced age Poor Lighting
Comorbidities Clutter
Polypharmacy Wet floor
.
FALLS RISK
Risk taking FACTORS Education level
Refuse walking aids
Qian, X.X. et al. (2020) Investigating Risk Factors for Falls among BEHAVIOURAL SOCIOECONOMIC
Community-Dwelling Older Adults According to WHO’s Risk Factor Model for Falls.
J Nutr Health Aging 25, 425–432
MODULE DEVELOPED BY :
SLIDE NO.
NATIONAL FALL PREVENTION AND
6
INTERVENTION STEERING COMMITTEE
Ministry of Health Malaysia
MINISTRY OF HEALTH MALAYSIA
PRECIPITATING CAUSES OF FALLS
Intrinsic Risk Factors
• Gait & balance impairment
• Peripheral neuropathy
• Vestibular Dysfunction
• Muscle weakness
• Vision impairment Precipitating Causes
• Medical illness
• Trips & slips
• Advanced age
• Impaired ADL
• Drop-attack
• Syncope
FALL
• Orthostasis
• Dizziness
• Drugs
Extrinsic Risk Factors
• Environmental hazards
• Poor footwear
• Restraints
JOSEPHSON ET AL. Falls and Their Prevention in Elderly People: What Does the Evidence Show? Med Clin N Am 90 (2006) 807–824
MODULE DEVELOPED BY :
SLIDE NO.
NATIONAL FALL PREVENTION AND
7
INTERVENTION STEERING COMMITTEE
Ministry of Health Malaysia
MINISTRY OF HEALTH MALAYSIA
CAUSES OF FALLS
INTRINSIC FACTORS
PARKINSON’S DISEASE POOR VISION
STROKE MENIERE’S
DEMENTIA DISEASE
ARRYHTYMIA
RENAL, LIVER, HEART FAILURE HYPOGLYCAEMIA
LUNG PATHOLOGY CAUSING HYPOXIA, POSTURAL
DECREASE EFFORT TOLERNCE HYPOTENSION
KNEE AND HIP INCONTINENCE
OSTEOARTHRIITS
PERIPHERAL NEUROPATHY
PERIPHERAL LOSS PROPRIOCEPTION
OEDEMA
MODULE DEVELOPED BY :
SLIDE NO.
NATIONAL FALL PREVENTION AND
8
INTERVENTION STEERING COMMITTEE
Ministry of Health Malaysia
MINISTRY OF HEALTH MALAYSIA
Identify individual COMPREHENSIVE CLOSE Monitoring of
risk factors ASSESSMENT MONITORING changes in condition
FALLS PREVENTION
MEASURES
Implementing care
Information sharing
base, environment and COLLABORATION &
MULTIFACETED COMMUNICATION and teamwork
educational measures
INTERVENTION
MODULE DEVELOPED BY :
SLIDE NO.
NATIONAL FALL PREVENTION AND
9
INTERVENTION STEERING COMMITTEE
Ministry of Health Malaysia
MINISTRY OF HEALTH MALAYSIA
FALLS GUIDELINES IN MALAYSIA
MODULE DEVELOPED BY :
SLIDE NO.
NATIONAL FALL PREVENTION AND
10
INTERVENTION STEERING COMMITTEE
Ministry of Health Malaysia
MINISTRY OF HEALTH MALAYSIA