On admission to RACFs, new residents should be assessed for fall risk using an evidence-based tool with clear links to interventions (level III-2).24
Risk assessment should be repeated every 6 months or in the event of a fall (level III-2).
Evidence of assessment and delivery of evidence-based fall prevention strategies should be included in RACFs accreditation processes (level V).
Medication should be reviewed annually by a pharmacist in association with the general practitioner, carers, residents, and family to identify medication-related problems and ensure appropriate prescribing (level II).
Psychotropic medications and medications aggravating the Drug Burden Index25 should specifically be reviewed in relation to fall risk. Use of benzodiazepines should be actively avoided in older people (level II).
Education is required around alternate methods to enhance sleep quality (daytime activity, avoiding naps, nonpharmacological aids to sleep) (level II).
Cholecalciferol should be considered for all residents (level II).
Multifactorial comprehensive assessment linked to tailored intervention should be routine practice in RACFs (level II).
Exercise as part of a multifactorial intervention is recommended. Exercise must challenge balance and be undertaken at least twice weekly (carers should be encouraged to assist) (level I).
Environmental assessment, which assesses the safe interaction of a resident with his or her environment should be part of a multifactorial intervention (level I).
Hip protectors should be recommended as part of a multifactorial intervention and targeted at people where adherence is likely to be good (level I).
Use of physical, mechanical, and chemical restraint is not recommended as a fall prevention strategy (level II).
