Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-05T08:10:03.584Z Has data issue: false hasContentIssue false
  • English
  • Français

Preventing falls and falls-injuries in hospitals and long-term care facilities

Part of: Bespoke shallow archive Weizmann

Published online by Cambridge University Press:  01 May 2007

David Oliver
David Oliver*
Affiliation:
University of Reading, School of Health & Social Care, Reading RG1 5AQ, UK
*
Address for correspondence: D. Oliver, University of Reading, School of Health & Social Care, Reading RG1 5AQ, UK.
Get access Rights & Permissions [Opens in a new window]

Extract

Falls are predominantly a problem of older people. In the UK, people over 65 currently account for around 60% of admissions and 70% of bed days in hospitals. There are approximately half a million older people in long-term care settings – many with frailty and multiple long-term conditions. The proportion of the population over 65 years is predicted to rise 25% by 2025, and that over 80 by 50%, with a similar increase in those with dependence for two or more activities of daily living. Despite policies to drive care to the community, it is likely that the proportion of older people in hospitals and care homes will therefore increase. Accidental falls are the commonest reported patient/resident safety incidents. Similar demographic trends can be seen in all developed nations, so that the growing problem of fall prevention in institutions is a global challenge. There has been far more focus in falls-prevention research on older people in ‘community’ settings, but falls are a pressing issue for hospitals and care homes, and a threat to the safety of patients and residents, even if a relatively small percentage of the population is in those settings at any one time.

Type
Clinical geriatrics
Information
Reviews in Clinical Gerontology , Volume 17 , Issue 2 , May 2007 , pp. 75 - 91
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Wanless, D (2006) [On behalf of Kings Fund.] Securing good care for older people. Taking a long-term view. London: Kings Fund, 2006. Available at http://www.kingsfund.org.uk/publications/kings_fund_publications/securing_good.html (accessed 20/08/07)Google Scholar
2Parker, S, Fadayevetan, R, Lee, S. Acute-hospital care for frail older people. Age Ageing 2006; 35: 551–52.CrossRefGoogle ScholarPubMed
3Bowman, C, Whistler, J, Ellerby, M. A national census of care-home residents. Age Aging. 2004: 33: 561–66.CrossRefGoogle ScholarPubMed
4Department of Health. A new ambition for old age: next steps in implementing the National Service Framework for Older People. London: Department of Health, 2006. Available at www.info4local.gov.uk/searchreport.asp?id=28951&frompage=whatsnew&subject=21 (accessed 17th Dec 2006)Google Scholar
5Hubbard, R.The ageing of the population; implications for multidisciplinary care in hospital. Age Ageing 2004; 33: 479–82.CrossRefGoogle ScholarPubMed
6Australian Commission on Safety and Quality in Healthcare. Preventing falls and harm from falls in older people. Best practice guidelines for Australian hospitals and residential aged care facilities. Canberra: Australian Commission, 2005 Available at http://www.safetyandquality.org/internet/safety/publishing.nsf/Content/falls (accessed 31/01/07)Google Scholar
7National Patient Safety Agency. Slips, trips and falls in hospital. London: NSPA, 2007.Google Scholar
8Registered Nurses Association of Ontario. Prevention of falls and fall injuries in the older adult. Nursing Best Practice Guidelines. Toronto, ON: RNAO, 2005.Google Scholar
9Rubenstein, LZ. Preventing falls in the nursing home. JAMA 1997; 278: 595–96.Google Scholar
10Oliver, D, Connelly, J, Victor, C et al. Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment. Systematic review and meta-analyses. BMJ 2007; 334: 82–87. (Full version on line BMJ.com November 2006)Google Scholar
11Rubenstein, LZ, Josephson, KR, Osterweil, D. Falls and falls prevention in the nursing home. Clin Geriatric Med; 1996: 12: 881–902.CrossRefGoogle ScholarPubMed
12Dickson, B, Woodward, M. Accident prevention in the elderly in nursing homes. Second year report. Newcastle: 2000. Gateshead, South Tyneside, Sunderland and Northumberland Registration and Inspection Areas for Care Homes, 2000.Google Scholar
13NICE Guideline 21. Falls: the assessment and prevention of falls in older people. London: 2004. National Institute for Clinical Excellence. Available at www.nice.org.uk. (accessed 18/11/07)Google Scholar
14Masud, T, Morris, R. Epidemiology of falls. Age Ageing 2001; 30 (suppl 1): 3–7.Google Scholar
15Vu, MQ, Weintraub, N, Rubenstein, LZ. Falls in the nursing home: are they preventable? J Am Med Dir Assoc 2005;6:S82–87.Google Scholar
16Morgan, I, Sahota, O, Wenn, R, Moran, C. Incidence of additional limb fractures in elderly patients presenting to secondary care with an osteoporotic hip fracture. Osteoporos Int 2004; (suppl 2): s30.Google Scholar
17Zjilstra, GA, Van Haagstret, J, van Rossum, E et al. Interventions to prevent fear of falling in community-dwelling older people. A systematic review. J Am Ger Soc 2007; 55: 603–15.CrossRefGoogle Scholar
18Mahoney, J. Immobility and falls in the acute care setting. Clin Ger Med 1998; 14: 699–72.Google Scholar
19Vetter, N, Ford, D. Anxiety and depression scores in elderly follows. Int J Geriatr Psych 1998; 4: 159–63.CrossRefGoogle Scholar
20Murphy, J, Isaacs, B. The post-fall syndrome. A study of 36 elderly inpatients. Gerontology 1982; 28: 265–70.CrossRefGoogle Scholar
21Bates, D, Pruess, K, Souney, P et al. Serious falls in hospitalized patients: correlates and resource utilization. Am J Med 1995; 99: 137–43.Google Scholar
22Oliver, D, Even, T, Wilmott, M et al. Do falls and falls-injuries in hospital indicate negligent care – and how big is the risk? A retrospective analysis of the NHS Litigation Authority Database of claims in negligence resulting from falls in hospitals in England 1995 to 2006. Qual Safety Healthcare 2007. (in press)CrossRefGoogle Scholar
23Oliver, D. Preventing falls and falls injuries in hospital. A major risk management challenge. Clin Risk 2007 (in press).Google Scholar
24Gastmans, C, Milisen, K. Use of physical restraints in nursing homes: clinical-ethical considerations. J Med Ethics 2006; 32: 148–52.Google Scholar
25Sammet, K. Autonomy of protection from harm. Judgement of German Courts on care for the elderly in nursing homes. J Med Ethics 2007; 33: 534–37.CrossRefGoogle ScholarPubMed
26Healey, F, Oliver, D, Milne, A. The use of bedrails to prevent falls and injuries. A systematic review and critique of the literature. Age Ageing 2008 (in press).Google Scholar
27Murray, GR, Cameron, ID, Cumming, RG. The consequences of falls in acute and subacute hospitals in Australia that result in proximal femoral fracture. J Am Ger Soc 2007; 55: 577–82.CrossRefGoogle Scholar
28Anon. Chapter 1. Epidemiology and risk factors for falls and falls-related injuries. In: Lord, S, Sherrington, C, Menz, H, Close, J. Falls in older people: risk factors and strategies for prevention, second edition. Cambridge: Cambridge University Press, 2007.CrossRefGoogle Scholar
29Rubenstein, LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing 2006; 35: ii37–ii41.Google Scholar
30Young, J, Inouye, S. Delirium in older people. BMJ 2007; 334: 842–46.Google Scholar
31The Royal College of Physicians of London. Audit of continence care in older people. London: RCP, 2006. Available at http://wwwcontinenceaudit2006.rcplondon.ac.uk (Accessed 18/11/07)Google Scholar
32Roberts, MS, Stoke, JA. Explicit evidence-based prescribing criteria. An important step in achieving quality therapeutics in nursing homes. Age Ageing 2003; 32: 6–7Google Scholar
33Passaro, A, Volpato, S, Romagnoni, F. Benzodiazepenes with a different half-life and falling in a hospitalised population. The GIFA Study. J Clin Epidemiol 2000; 53: 1222–29.Google Scholar
34Shibao, C, Gryalva, C, Raj, S et al. Orthostatic hypotension-related hospitalisations in the United States. Am J Med 2007; 120: 975–80.CrossRefGoogle ScholarPubMed
35Alzheimer's Association. Who cares wins. Improving the care of older people with dementia admitted to general hospital. London: Alzheimer's Association, 2005. Available at: www.alzheimers.org.uk/working_with_people_with_dementia/PDF/whocareswins.pdf (accessed 15/11/07)Google Scholar
36Shaw, FE. Falls in cognitive impairment and dementia. Clin Geriatr Medicine. 18:159–73, 2002.Google Scholar
37Myers, H. Hospital falls risk assessment tools: a critique of the literature. Int J Nurs Pract 2003; 9: 233–35.CrossRefGoogle ScholarPubMed
38Oliver, , McMurdo, M, Daly, F, Martin, F. Risk factors and risk assessment tools for falls in hospital inpatients. A systematic review. Age Ageing 2004; 33: 122–30CrossRefGoogle ScholarPubMed
39Scott, V, Votova, K, Scanlan, A et al. Multifactorial and functional mobility assessment tools for falls risk among older adults in the community, home-support, long-term care and acute settings. Age Ageing 2007; 36: 130–40.CrossRefGoogle Scholar
40Inouye, SK. Prevention of delirium in older hospitalised patients: risk factors and targeted intervention strategies. Ann Med 2000; 32: 257–73.CrossRefGoogle ScholarPubMed
41Zermansky, A., Alldred, D, Petty, D et al. Clinical medication review by a pharmacist of elderly people living in care-homes: randomised controlled trial. Age Ageing 2006; 35: 586–91.CrossRefGoogle ScholarPubMed
42Reuben, DB, Borok, GM, Wolde-Tsadik, G et al. A randomised controlled trial of comprehensive geriatric assessment in the care of older hospitalised patients. N Engl JMed 1995; 332: 1345–50.Google Scholar
43Mahoney, J. Immobility and falls. Clin Geriatr Med 1998; 14:699–72.Google Scholar
44Morse, JM.Preventing patient falls, second edition. Thousand Oaks CA: Sage Publications, 2000.Google Scholar
45Anon: Chapter 2: Environmental risk factors for falls. In: Lord, S, Sherrington, C, Menz, H, Close, J. Falls in older people, second edition. Cambridge: 2007, Cambridge University Press, 2007.Google Scholar
46Evans, DA, Hodgkinson, B, Lambert, L et al. Falls in acute hospitals: a systematic review. Adelaide: The Joanna Briggs Institute for Evidence-Based Nursing and Midwifery: 1998.Google Scholar
47Healey, F, Scobie, S, Oliver, D et al. Falls in English and Welsh Hospitals. Results of national observational study based on retrospective analysis of 12 months’ incident reporting. Qual Safety Healthcare 2007. (In press)Google Scholar
48Vassallo, M, Sharma, JC, Briggs, R et al. Characteristics of early fallers on elderly-care rehabilitation wards. Age Ageing 2003; 32: 338–42.Google Scholar
49Von Renteln-Kruse, W, Krause, T. Falls events in geriatric hospital patients. Results of incident recording over three years. Z Gerontol Geriatr 2004; 37: 9–12.Google Scholar
50Thomas, EJ, Brewer, TA. Incidents and preventable adverse events in elderly patients. A population study. BMJ 2000; 320: 741–17.Google Scholar
51Fonda, D, Cook, J, Sandler, V, Baily, M. Reducing serious falls-related injuries in hospital. Med J Australia 2006; 184: 379–82.CrossRefGoogle Scholar
52Von Renteln-kruse, W, Krause, T. Incidence of in-hospital falls in geriatric patients before and after the introduction of an interdisciplinary team–based fall-prevention intervention. J Am Ger Soc 2007; (Online Early Articles). doi:10.1111/j.1532-5415.2007.01424.x (accessed 18/11/07)CrossRefGoogle Scholar
53Oliver, D. Assessing risk of falls in hospital. Time for a rethink? Can J Nurs Res 2006; 38: 89–94Google ScholarPubMed
54Oliver, D. Falls risk-assessment tools for hospital patients. Are they a waste of time? BMJ Safer Healthcare 2007. Avaliable at; http://www.saferhealthcare.org.uk/ihi/search/searchresults.aspx?searchterm=falls&searchtype=basic&Start+Search.x=15&Start+Search.y=13 (Accessed 19/11/07)Google Scholar
55Morse, JM. The safety of safety research: the case of patient fall research. Can J Nurs Res 2006; 38: 74–88.Google Scholar
56Haines, TP, Hill, K, Walshe, W et al. Design-related bias in hospital falls-risk screening-tool predictive accuracy evaluations: systematic review and meta-analysis. J Gerontol 2007; 62A: 664–72.Google Scholar
57Wyatt, J, Altman, D. Prognostic models: clinically useful or quickly forgotten? BMJ 1995: 311: 539–41.Google Scholar
58Anon Chapter 14 Measuring the characteristics of measures. In: Bowers, D, House, A, Owens, D. Understanding clinical papers. Chichester: John Wiley, 2003: 81–85.Google Scholar
59Oliver, D, Britton, M, Seed, P, Martin, FC, Hopper, AH. Development and evaluation of an evidencebased risk-assessment tool (STRATIFY) to predict which elderly inpatients will fall: case-control and cohort studies. BMJ 1997; 315 (7118): 1309.Google Scholar
60Vassalo, M, Stockdase, R, Sharma, JD, Briggs, R, Allen, S. A comparative study of the use of four fall-risk assessment tools on acute medical words. JA.Google Scholar
61Oliver, D, Papaiaoannou, A, Foster, G et al. The utility of the STRATIFY score in predicting falls in older hospital patients. Systematic review and meta-analyses. J Am Geriatr Soc 2007 (in press).Google Scholar
62Coker, E. Don't just do something. Do something that works! Risk-prediction and reduction in older people. Safer Healthcare 2007. Available at http://www.saferhealthcare.org.uk/IHI/Topics/ManagingChange/SafetyStories/11817_Don%E2%80%99t_just_do_something_do_something_that_works.htm (Accessed 19/11/07)Google Scholar
63Scobie, S. Keeping your balance. Slips, trips and falls in hospital. Safer Healthcare 24th July 2007 Available at http://www.saferhealthcare.org.uk/IHI/Topics/ManagingChange/Features/11577_Keeping_your_balance_slips_trips_and_falls_in_hospital.htm (Accessed 19/11/07)Google Scholar
64Oliver, D. Prevention of falls in hospital inpatients: agendas for research and practice. Age Ageing 2004; 33: 328–30.Google Scholar
65Oliver, D, Masud, T. Preventing falls and injuries in care-homes. Age Ageing 2004; 33: 1–3.Google Scholar
66Oliver, D, Hopper, A, Seed, P et al. Do hospital fall-prevention programs work? A systematic review. J Am Geriatr Soc 2000; 48: 63–67.Google Scholar
67Streiner, DL, Normal, GR, Blum, HM. PDQ Epidemiology. Toronto, ON: 1989. Decker, 1989: 33–38.Google Scholar
68Campbell, M, Elbourne, D, Altman, D. Consort statement: extension to cluster randomised controlled trials. BMJ 2004; 328:702–08.CrossRefGoogle Scholar
69Evans, D, Wood, J, Lambert, L. A review of physical restraint minimisation in the acute-care setting. J Adv Nurs 2002; 40: 616–25.Google Scholar
70Healey, F, Stevenson, E, Oliver, D. A national bedrail safety project to help reduce falls. Nursing Times 2007; 103: 21: 30–33.Google Scholar
71Simpson, A, Lamb, S, Roberts, P. Does the type of flooring affect the risk of hip fracture? Age Ageing 2004; 33: 242–46.CrossRefGoogle ScholarPubMed
72Lamb, SE, Jorstad-Stein, EC, Hauer, K et al. Prevention of Falls Network Europe (PROFANE) Outcomes Consensus Group. Development of a common outcome dataset for fall-injury prevention trials. J Am Geriatr Soc 2005; 53: 1618–22.Google Scholar
73Shorr, R, Mion, L, Rosenblatt, L, Lynch, D, Kessler, L. Ascertainment of patient falls in hospital using an evaluation service: comparison with incident reports. J Am Geriatr Soc 2007; 55 (suppl): S1–246.Google Scholar
74Sutton, J, Standan, P, Wallace, A. Patient accidents in hospital; incidence, documentation and significance. Br J Clin Pract 1994; 48:63–66.CrossRefGoogle ScholarPubMed
75Sari, AB, Sheldon, TA, Cracknell, A et al. Sensitivity of a routine system for reporting patient safety incidents in an NHS hospital. BMJ 2007; 334: 79.Google Scholar
76Cameron, I, Murray, GR, Gillespie, LD et al. Interventions for preventing falls in older people in residential care facilities and hospitals. Cochrane Database of Systematic Reviews (ongoing). Protocol available at: http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD005465/frame.html (accessed 12/11/07).Google Scholar
77American Geriatrics Society, British Geriatrics Society, American Association of Orthopaedic Surgeons Panel on Falls Prevention. Guideline for the prevention of falls in older persons. J Am Geriatr Soc 2001; 49: 664–72.Google Scholar
78Chang, J, Morton, S, Rubenstein, L et al. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomized clinical trials. BMJ 2004; 328 (7441): 653–54.Google Scholar
79Gillespie, LD, Gillespie, WJ, Robertson, MC et al. (Last update 2003) Interventions for preventing falls in elderly people. Cochrane Database of Systematic Reviews. Art. No: CD000340. DOI: 10.1002/14651858.CD000340Google Scholar
80Kannus, P, Sievanen, H, Palvanen, et al. The prevention of falls and fall-related injuries. Lancet 2005; 366: 1885–93.CrossRefGoogle Scholar
81Cameron, ID, Kurrle, S. Preventing falls in elderly people living in hospitals and care homes. BMJ 2007;334:53–54.Google Scholar
82Healey, F, Monro, A, Cockram, A et al. Using targeted risk factor reduction to prevent falls in older hospital inpatients. Age Ageing 2004; 33: 390–95.CrossRefGoogle Scholar
83Haines, T, Bennell, K, Osborne, R et al. Effectiveness of targeted falls prevention programmes in the subacute setting. BMJ 2004; 328: 676–79.Google Scholar
84Jensen, J, Nyberg, L, Gustafson, Y et al. Fall and injury prevention in residential care – effects in residents with higher and lower levels of cognition. J Am Geriatr Soc 2003; 51: 627–35.CrossRefGoogle ScholarPubMed
85Jensen, J, Lundin-Olson, L, Nyberg, L et al. Fall and injury prevention in older people living in residential care facilities: a cluster-randomised trial. Ann Int Med 2002; 136: 733–41.CrossRefGoogle Scholar
86Becker, C, Kron, M, Lindemann, U et al. Effectiveness of a multifaceted intervention on falls in nursing home residents. J Am Geriatr Soc 2003; 51: 306–13.Google Scholar
87Dyer, C, Taylor, G, Reed, M et al. Falls prevention in residential care-homes: randomised controlled trial. Age Ageing 2004; 33: 596–602.CrossRefGoogle ScholarPubMed
88Parker, MJ, Gillespie, W, Gillespie, LJ. Effectiveness of hip protectors for preventing hip fractures in elderly people: systematic review. BMJ 2006; 332: 571–74.Google Scholar
89Honkanen, RL, Schackman, BR, Mushlin, A et al. A cost-effectiveness analysis of hip protectors in the nursing home setting. J Am Geriatr Soc 2005; 53: 190–197.Google Scholar
90Oliver, D, Allain, T, Connelly, J. Economic modelling on cost-effectiveness of hip- protectors in institutionalised older people based on contentious interpretation of original effectiveness data. J Am Ger Soc Dec 2005 53: 2241–42.Google Scholar
91O'Halloran, P. Hip protectors; a fall from grace. BMJ Safer Healthcare, 2007; July. Available at: http://www.saferhealthcare.org.uk/IHI/Topics/ManagingChange/Features/12005_HipProtectorsA+FallFromGrace.htm (accessed 13/11/07)Google Scholar
92Honkanen, LA, Monaghan, M, Reid, MC et al. Can hip protector use in the nursing home be predicted? J Am Geriatr Soc 2006; 12 December Online Early. Available at: http://www.blackwell-synergy.com/doi/abs/10.1111/j.15325415.2006.01015.x (accessed 13/11/07)Google Scholar
93Burl, J, Centralo, D, Bower, D et al. Hip protector compliance. a thirteen-month study of factors affecting compliance in a long-term care facility. J Am Med Dir Assoc 2003; 4: 245–50.Google Scholar
94Minns, RJ, Marsh, AM, Chuck, A et al. Are hip protectors correctly positioned in use? Age Ageing 2007. Online first (February). Available at: http://ageing.oxfordjournals.org/cgi/content/abstract/afl186v1 (Accessed 19/11/07)Google Scholar
95O'Halloran, PD, Cran, GW, Berringer, TR et al. A cluster-randomised trial to evaluate a policy of making hip protectors available to residents of nursing homes. Age Ageing 2004; 33: 582–88Google Scholar
96USA Food and Drug Administration. Hospital bed system dimensional and assessment guidance to reduce entrapment from bedrails. Washington: FDA. 2004. Available at: http://www/fda.gov/cdrh/beds/guidanceGoogle Scholar
97Medicines and Healthcare Products Regulatory Agency. Safe use of bedrails. London: 2006. MHRA. Available at www.mhra.gov.ukGoogle Scholar
98Evans, D, Wood, J, Lambert, L. A review of physical restraint minimisation in the acute- care setting. J Adv Nurs 2002; 40: 616–25Google Scholar
99Frengley, J, Mion, L. Physical restraints in the acute-care setting. Issues and future direction. Clin Geriatr Med 1998; 144: 727–43.Google Scholar
100National Patient Safety Agency. Bedrails – reviewing the evidence. A systematic literature review. London: NPSA, 2007.Google Scholar
101Walsh, K, Bennett, G. Restraint: Is it ever necessary in the care of older people? Geriatr Med 2000; 30: 24–27.Google Scholar
102George, J, Bleasdale, S, Singleton, S. Causes and prognosis of delirium in elderly patients admitted to hospital. Age Ageing 1997; 6: 423–27Google Scholar
103Johnston, C, Liddle, J. The Mental Capacity Act 2005; a new framework for decision–making. J Med Ethics 2007; 33: 94–97.CrossRefGoogle ScholarPubMed
104Dibartolo, V. Nine steps to effective restraint use. Reg Nurse 1998; 61: 23–24.Google Scholar
105National Patient Safety Agency. Resources for reviewing and developing a bedrail policy. London. 2007. NPSA.Google Scholar
106Miskelly, F. Electronic bed and chair monitors for the prevention of falls. Safer Healthcare. 21 October, 2007. Available at: http://www.saferhealthcare.org.uk/IHI/Topics/GroundsforAction/Features/12302_Electronic_bed_chair_monitors_for_prevention_of_falls.htm (Accessed 19/11/07)Google Scholar
107Kelly, KE, Phillips, CL et al. Evaluation of a non-intrusive monitor to reduce falls in nursing home patients. J Am Med Dir Assoc 2002; 3:388–82.Google Scholar
108Tideiksaar, R, Feiner, CF, Maby, J. Falls prevention: the efficacy of a non- intrusive falls monitor in an acute-care setting. Mount Sinai Med J 1993; 60: 522–27.Google Scholar
109Donald, IP, Pitt, K, Armstrong, E et al. Preventing falls on an elderly care rehabilitation ward. Clin Rehabil 2000; 14: 178–85.Google Scholar
110Mulrow, CD, Gerety, MB, Kanten, D et al. A randomised controlled trial of rehabiliation for very frail nursing-home residents. JAMA 1994; 271: 519–24.Google Scholar
111Whitney, J. Exercise interventions to prevent falls. In: Lord, S, Sherrington, C, Menz, H, Close, J. Falls in older people: risk factors and strategies for prevention, second edition. Cambridge: Cambridge University Press,2007: 177–202.Google Scholar
112Haines, TP, Hill, KD, Bennell, KL et al. Additional exercise for older subacute hospital inpatients to prevent falls: benefits and barriers to implementation and evaluation. Clin Rehabil 2007;21: 742–53.CrossRefGoogle ScholarPubMed
113Connell, BR. Role of the environment in falls prevention. Clin Geriatr Med 1996; 12:859–80.Google Scholar
114Legood, R, Scuffham, P, Cryer, C. Are we blind to injuries in the visually impaired? A review of the literature. Injury Prev 2002; 8: 155–60.Google Scholar
115Healey, F. Does flooring type affect the risk of injury in older adults? Nurs Times 1994; 90: 40–41.Google Scholar
116Allain, T, Dhesi, J, Hypovitaminosis D in older adults. Gerontology 2003; 49: 273–78.Google Scholar
117Allain, T, Bearne, L, Swift, CG et al. Postural stability and vitamin D status in elderly people who fall. Age Ageing 2001;30; 88–90.Google Scholar
118Anderson, F. Vitamin D for older people: how much? For whom? And above all–why? Age Ageing 2005; 34: 425–26.Google Scholar
119Chapuy, M, Arlot, M, Duboeuf, F et al. Vitamin D3 and calcium to prevent hip fractures in elderly women. NEJM 1992; 327:1637–42.Google Scholar
120Bischoff, HA, Stahelin, HB, Dick, W et al. Effects of calcium and vitamin D supplementation on falls. A randomised controlled trial. J Bone Min Res 2003; 18:343–51.Google Scholar
121Francis, R. The role of vitamin D, calcium and vitamin D and the vitamin D metabolites in the prevention of falls and fractures. London: National Library for Health. Musculoskeletal Specialist Library, 2007. Available at http://www.library.nhs.uk/musculoskeletal/viewResource.aspx?resID=126504&code=504b8ca12d8935d2ef5b3f53864d34a8 (accessed 19/11/07)Google Scholar
122Francis, RM, Anderson, FH, Patel, S, Sahota, O, van Staal, TP. Calcium and vitamin D in the prevention of osteoporotic fractures. QJM 2006: 99: 355–63.Google Scholar
123Law, M. Withers, H, Morris, J, Anderson, F. Vitamin D supplementation and the prevention of fractures and falls: results of a randomised trial in elderly people in residential accommodation. Age Ageing 2006;35: 482–86.CrossRefGoogle ScholarPubMed
124Flicker, L, MacInnis, RJ, Stein, MS et al. Should older people in residential care receive vitamin D to prevent falls? Results of a randomized trial. J Am Geriatr Soc 2005; 53: 1881–88.Google Scholar
125Lyons, R, Johansen, A, Brophy, S et al. Preventing fractures among older people living in institutional care: a pragmatic randomised double-blind placebo controlled trial of vitamin D supplementation. Osteoporosis Int 2007;18: 811–18.Google Scholar
126Broe, KE, Chen, TC, Weinberg, J et al. A higher dose of vitamin D reduces the risk of falls in nursing home residents. A randomised, multiple-dose study. J Am Geriatr Soc 2007; 55:234–39, 2007.Google Scholar
127Burleigh, E, McColl, J, Potter, J. Does vitamin D stop inpatients falling? A randomised controlled trial. Age Ageing 2007 36:507–13Google Scholar
128Anon: Chapter 7 Medications as risk factors for falls. In: Lord, S, Sherrington, C, Menz, H, Close, J. Falls in older people: risk factors and strategies for prevention, second edition. Cambridge: Cambridge University Press, 2007: 133–151.CrossRefGoogle Scholar
129Haumschild, M, Karfonta, TL, Haumschild, MS et al. Clinical and economic outcomes of a fall-focussed pharmaceutical intervention programme. Am J Health Sys Pharm 2003; 60:1029–132.CrossRefGoogle Scholar