Course A13 Test 7168 Preventing Falls, 3 CE-hours, $21
Professor Rudolf Klimes, PhD, welcomes you to this online course. Keep going.
START the course here. TAKE the exam at the end. PAY after the exam.
Fall Prevention, 3 CE hrs
Course Description: This course explores fall prevention, primarily reasons for increased fall incidents and recommendations to to prevent ongoing falls. The scope of fall prevention is vast and many are at risk. Fortunately, this is a crises that can often be avoided by maintaining consistent daily health practices.
Objectives: In this course the following objective will be met. 1) How big is the problem 2) What outcomes are linked to falls in the elderly 3) Who is at risk 4) How can older adults prevent falls 5) How to maintain healthy bones 5) Basic information on bone diseases 6) Basic tips on fall prevention in children 6) Available resources and references
Course Format: Online linked resources and lectures that you can use anytime 24/7. One multi-choice test.
Course Developers and Instructors: R. Klimes, PhD, MPH (John Hopkins U), well known author and scholar in health-related research and health behaviors. Co-author Dr. Heather Hawkins is a scholar in Patient Safety and prevention modalities.
Course Time: About three hours for online study, test taking with course evaluation feedback and certificate printing.
3 CE hours course accredited by the California Board of Registered Nursing
What do you know? Preliminary quizzes.
Falls and Older Adults Quizzes
Test your knowledge about Falls and Older Adults by taking one of these quizzes:
Falls Among Older Adults
Each year, millions of adults aged 65 and older fall.1 Falls can cause moderate to severe injuries, such as hip fractures and head traumas, and can increase the risk of early death. Fortunately, falls are a public health problem that is largely preventable.
- One out of three older adults (those aged 65 or older) falls each year but less than half talk to their healthcare providers about it.
- Among older adults, falls are the leading cause of both fatal and nonfatal injuries.
- In 2012, 2.4 million nonfatal falls among older adults were treated in emergency departments and more than 722,000 of these patients were hospitalized.
- In 2012, the direct medical costs of falls, adjusted for inflation, were $30 billion.
- Twenty to thirty percent of people who fall suffer moderate to severe injuries such as lacerations, hip fractures, and head traumas. These injuries can make it hard to get around or live independently, and increase the risk of early death.
- Falls are the most common cause of traumatic brain injuries (TBI).
- In 2000, 46% of fatal falls among older adults were due to TBI.
- Most fractures among older adults are caused by falls. The most common are fractures of the spine, hip, forearm, leg, ankle, pelvis, upper arm, and hand.
- Many people who fall, even if they are not injured, develop a fear of falling. This fear may cause them to limit their activities, which leads to reduced mobility and loss of physical fitness, and in turn increases their actual risk of falling.
- The death rates from falls among older men and women have risen sharply over the past decade.
- In 2011, about 22,900 older adults died from unintentional fall injuries.
- Men are more likely than women to die from a fall. After taking age into account, the fall death rate in 2011 was 41% higher for men than for women.
- Older whites are 2.7 times more likely to die from falls as their black counterparts.
- Rates also differ by ethnicity. Older non-Hispanics have higher fatal fall rates than Hispanics.
- People age 75 and older who fall are four to five times more likely than those age 65 to 74 to be admitted to a long-term care facility for a year or longer.
- Rates of fall-related fractures among older women are more than twice those for men.
- Over 95% of hip fractures are caused by falls.15 In 2010, there were 258,000 hip fractures and the rate for women was almost twice the rate for men.
- White women have significantly higher hip fracture rates than black women.
Older adults can stay independent and reduce their chances of falling.18,19 They can:
- Exercise regularly. It is important that the exercises focus on increasing leg strength and improving balance, and that they get more challenging over time. Tai Chi programs are especially good.
- Ask their doctor or pharmacist to review their medicines—both prescription and over-the counter—to identify medicines that may cause side effects or interactions such as dizziness or drowsiness.
- Have their eyes checked by an eye doctor at least once a year and update their eyeglasses to maximize their vision. Consider getting a pair with single vision distance lenses for some activities such as walking outside.
- Make their homes safer by reducing tripping hazards, adding grab bars inside and outside the tub or shower and next to the toilet, adding railings on both sides of stairways, and improving the lighting in their homes.
To lower their hip fracture risk, older adults can:
- Get adequate calcium and vitamin D—from food and/or from supplements.
- Do weight bearing exercise.
- Get screened and, if needed, treated for osteoporosis.
One out of three older adults (those aged 65 or older) falls each year, but less than half talk to their healthcare providers about it. Among older adults, falls are the leading cause of both fatal and nonfatal injuries.
Falls don’t ‘just happen’ and people don’t fall just because they get older. Falls are more likely with:
- Muscle weakness, especially in the legs,
- Problems with balance and/or gait – how someone walks, or
- Certain medications.
There are many other reasons as well! Use this excellent checklist and screening tools created by the Alaskan Department of health to assess your risk. Information about Falls Risk Factor Assessments and Tests
Falls are serious at any age, but especially for older people who are more likely to break a bone when they fall.
If you have a disease called osteoporosis, you are more likely to break a bone if you fall. Osteoporosis is called the “silent disease” because bones become weak with no symptoms. You may not know that you have it until a strain, bump, or fall causes a bone to break.
Falls are especially dangerous for people with osteoporosis. If you break a bone, you might need a long time to recover. Learning how to prevent falls can help you avoid broken bones and the problems they can cause.
- Why Do People Fall?
- How Can I Prevent Falling?
- How Can I Prevent Broken Bones if I Fall?
- How Can I Keep My Bones Healthy?
Some of the reasons people fall are:
- Tripping or slipping due to loss of footing or traction
- Slow reflexes, which make it hard to keep your balance or move out of the way of a hazard
- Balance problems
- Reduced muscle strength
- Poor vision
- Taking medicines
- Drinking alcohol.
Illness and some medicines can make you feel dizzy, confused, or slow. Medicines that may increase the risk of falls are:
- Blood pressure pills
- Heart medicines
- Diuretics (water pills)
- Muscle relaxants
- Sleeping pills.
Drinking alcohol can lead to a fall because it can:
- Slow your reflexes
- Cause you to feel dizzy or sleepy
- Alter your balance
- Cause you to take risks that can lead to falls.
At any age, people can make changes to lower their risk of falling. Some tips to help prevent falls outdoors are:
- Use a cane or walker
- Wear rubber-soled shoes so you don’t slip
- Walk on grass when sidewalks are slick
- Put salt or kitty litter on icy sidewalks.
Some ways to help prevent falls indoors are:
- Keep rooms free of clutter, especially on floors
- Use plastic or carpet runners
- Wear low-heeled shoes
- Do not walk in socks, stockings, or slippers
- Be sure rugs have skid-proof backs or are tacked to the floor
- Be sure stairs are well lit and have rails on both sides
- Put grab bars on bathroom walls near tub, shower, and toilet
- Use a nonskid bath mat in the shower or tub
- Keep a flashlight next to your bed
- Use a sturdy stepstool with a handrail and wide steps
- Add more lights in rooms
- Buy a cordless phone so that you don’t have to rush to the phone when it rings and so that you can call for help if you fall.
You can also do exercises to improve your balance. While holding the back of a chair, sink, or counter:
- Stand on one leg at a time for a minute and then slowly increase the time. Try to balance with your eyes closed or without holding on.
- Stand on your toes for a count of 10, and then rock back on your heels for a count of 10.
- Make a big circle to the left with your hips, and then to the right. Do not move your shoulders or feet. Repeat five times.
Sometimes you cannot prevent a fall. If you do fall, you can try to prevent breaking a bone. Try to fall forwards or backwards (on your buttocks), because if you fall to the side you may break your hip. You can also use your hands or grab things around you to break a fall. Some people wear extra clothes to pad their hips or use special hip pads.
Some ways to protect your bones are:
- Get enough calcium and vitamin D each day.
- Walk, climb stairs, lift weights, or dance each day.
- Talk with your doctor about having a bone mineral density (BMD) test.
- Talk with your doctor about taking medicine to make your bones stronger.
Recommended Calcium and Vitamin D Intakes
|Life-stage group||Calcium mg/day||Vitamin D (IU/day)|
|Infants 0 to 6 months||200||400|
|Infants 6 to 12 months||260||400|
|1 to 3 years old||700||600|
|4 to 8 years old||1,000||600|
|9 to 13 years old||1,300||600|
|14 to 18 years old||1,300||600|
|19 to 30 years old||1,000||600|
|31 to 50 years old||1,000||600|
|51- to 70-year-old males||1,000||600|
|51- to 70-year-old females||1,200||600|
|>70 years old||1,200||800|
|14 to 18 years old, pregnant/lactating||1,300||600|
|19 to 50 years old, pregnant/lactating||1,000||600|
Definitions: mg = milligrams; IU = International Units
Source: Food and Nutrition Board, Institute of Medicine, National Academy of Sciences, 2010.
For More Information About Osteoporosis and Other Related Conditions:
NIH Osteoporosis and Related Bone Diseases ~ National Resource Center
Toll free: 800-624-BONE (2663)
National Institute on Aging
For the NIA publication on fall prevention, go to: www.nia.nih.gov/HealthInformation/Publications/falls.htm
American Geriatrics Society
The NIH Osteoporosis and Related Bone Diseases~National Resource Center acknowledges the assistance of the National Osteoporosis Foundation in the preparation of this publication.
For Your Information
This publication may contain information about medications used to treat the health condition discussed here. When this publication was printed, we included the most up-to-date (accurate) information available. Occasionally, new information on medication is released.
For updates and for any questions about any medications you are taking, please contact the U.S. Food and Drug Administration at:
U.S. Food and Drug Administration
Toll Free: 888–INFO–FDA (888–463–6332)
NIH Osteoporosis and Related Bone Diseases ~ National Resource Center
The NIH Osteoporosis and Related Bone Diseases ~ National Resource Center provides patients, health professionals, and the public with an important link to resources and information on metabolic bone diseases. The mission of NIH ORBD~NRC is to expand awareness and enhance knowledge and understanding of the prevention, early detection, and treatment of these diseases as well as strategies for coping with them.
The NIH Osteoporosis and Related Bone Diseases ~ National Resource Center is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases with contributions from:
- National Institute on Aging
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- National Institute of Dental and Craniofacial Research
- National Institute of Diabetes and Digestive and Kidney Diseases
- NIH Office of Research on Women’s Health
- HHS Office on Women’s Health.
We all want to keep our children safe and secure and help them live to their full potential. Knowing how to prevent leading causes of child injury, like falls, is a step toward this goal.
Falls are the leading cause of non-fatal injuries for all children ages 0 to 19. Every day, approximately 8,000 children are treated in U.S. emergency rooms for fall-related injuries. This adds up to almost 2.8 million children each year.
Thankfully, many falls can be prevented, and parents and caregivers can play a key role in protecting children.
Play safely. Falls on the playground are a common cause of injury. Check to make sure that the surfaces under playground equipment are safe, soft, and well- maintained (such as wood chips or sand, not dirt or grass).
Make your home safer. Use home safety devices, such as guards on windows that are above ground level, stair gates, and guard rails. These devices can help keep a busy, active child from taking a dangerous tumble.
Keep sports safe. Make sure your child wears protective gear during sports and recreation. For example, when in-line skating, use wrist guards, knee and elbow pads, and a helmet.
Supervision is key. Supervise young children at all times around fall hazards, such as stairs and playground equipment, whether you’re at home or out to play.
Falls: Playground Safety
Each year in the United States, emergency departments treat more than 200,000 children ages 14 and younger for playground-related injuries (Tinsworth 2001).
Occurrence and Consequences
- About 45% of playground-related injuries are severe–fractures, internal injuries, concussions, dislocations, and amputations (Tinsworth 2001).
- About 75% of nonfatal injuries related to playground equipment occur on public playgrounds (Tinsworth 2001). Most occur at schools and daycare centers (Phelan 2001).
- Between 1990 and 2000, 147 children ages 14 and younger died from playground-related injuries. Of them, 82 (56%) died from strangulation and 31 (20%) died from falls to the playground surface. Most of these deaths (70%) occurred on home playgrounds (Tinsworth 2001).
In 1995, playground-related injuries among children ages 14 and younger cost an estimated $1.2 billion (Office of Technology Assessment 1995).
Groups at Risk
- While all children who use playgrounds are at risk for injury, girls sustain injuries (55%) slightly more often than boys (45%) (Tinsworth 2001).
- Children ages 5 to 9 have higher rates of emergency department visits for playground injuries than any other age group. Most of these injuries occur at school (Phelan 2001).
- On public playgrounds, more injuries occur on climbers than on any other equipment (Tinsworth 2001).
- On home playgrounds, swings are responsible for most injuries (Tinsworth 2001).
- A study in New York City found that playgrounds in low-income areas had more maintenance-related hazards than playgrounds in high-income areas. For example, playgrounds in low-income areas had significantly more trash, rusty play equipment, and damaged fall surfaces (Suecoff 1999).
Falling Prevention Library http://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/
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- Hayes WC, Myers ER, Morris JN, et al. Impact near the hip dominates fracture risk in elderly nursing home residents who fall. Calcified Tissue International 1993; 52:192–198.
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- National Hospital Discharge Survey (NHDS), National Center for Health Statistics. Available at:www.cdc.gov/nchs/hdi.htm. Assessed September 14, 2011.
- Gillespie, LD, Robertson, MC, Gillespie, WH, Sherrington C, Gates S, Clemson LM, Lamb SE. Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews 2012, Issue 9. Art. No.: CD007146. DOI: 10.1002/14651858.CD007146.pub3.
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Recommendations for you: Visit our Preventing Medication Errors Class (http://cecourses.org/preventive-care/preventing-medical-errors-2/), to learn how to distinguish the common types of medical errors and how they can be prevented, improve patient safety through various procedures, learn protocols and policies that impact patients, list the common medication errors that can make a medical setting unsafe for patients, discuss the prevention of medication errors in various settings for different populations, and evaluate the various reporting systems and approaches that deal with medication errors.