Falls Prevention

A fall is usually the visible result of several interacting risks rather than one isolated mistake. Impaired balance may combine with a sedating medication, orthostatic hypotension, poor lighting, unfamiliar surroundings, delirium, or an attempt to toilet without assistance. Effective prevention therefore asks not merely, “What score did this patient receive?” but, “What made this person likely to fall here, today, and what intervention changes that mechanism?” The advanced practice nurse translates that reasoning into care processes. This includes selecting an appropriate screening pathway, coordinating assessment and referrals, prescribing or facilitating evidence-based interventions, and building a system that reliably carries the plan from one shift or visit to the next. A fall-prevention program is not successful because a risk form is complete; it is successful when identified risks produce specific actions and those actions are delivered consistently. In community-dwelling adults aged 65 years or older who are at increased risk, the USPSTF gives exercise interventions a Grade B recommendation. It gives a Grade C recommendation for multifactorial interventions, meaning the decision to offer them should be individualized after considering the patient's...