Geriatric Falls: A Registry-Based Study in the Netherlands

Verbeek, Frank H. O.; Ham, Wietske H. W.; Verbeek, A.L.M.; Ginkel, Janneke M. de Man‐van; Os‐Medendorp, Harmieke van; Westers, Paul; Leenen, Luke P. H.

doi:10.1097/jtn.0000000000000648

Journal of Trauma Nursing

2022

DOI: 10.1097/jtn.0000000000000648

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Geriatric Falls: A Registry-Based Study in the Netherlands

Frank H. O. Verbeek

Wietske H. W. Ham

A.L.M. Verbeek

et al.

Abstract: RESEARCH BACKGROUNDA fall incident is defined as an unintentional and unexpected event in which a person comes to rest on the ground or at a lower level (Lamb et al., 2005). In the United States, the rate of fall incidents in people 65 years and older, who were evaluated at the emergency department (ED), increased by 27% over the period

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2024

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Cited by 2 publications

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Trends and projections in fall death in the Netherlands from 1990 to 2045

van der Naald,

Verbeek,

Baden

et al. 2024

Emerg Med J

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BackgroundIncreasing life expectancy in high-income countries has been linked to a rise in fall mortality. In the Netherlands, mortality rates from falls have increased gradually from the 1950s, with some indication of stabilisation in the 1990s. For population health and clinical practice, it is important to foresee the future fall mortality trajectories.MethodsA graphical approach was used to explore trends in mortality by age, calendar period and cohorts born in the periods of 1915–1945. Population data and the numbers of people with accidental fall fatality as underlying cause of death from 1990 to 2021 were derived from Statistics Netherlands. Age-standardised mortality rates of unintentional falls per 100 000 population were calculated by year and sex. A log-linear model was used to examine the separate effects of age, period and cohort on the trend in mortality and to produce estimates of future numbers of fall deaths until 2045.ResultsWhile the total population increased by 17% between 1990 and 2021, absolute numbers of fall-related deaths rose by 230% (from 1584 to 5234), which was 251% (an increase of 576 deaths in 1990 to 2021 deaths in 2020) for men and 219% (from 1008 to 3213) for women. Age-standardised figures were higher for women than men and increased more over time. In 2020, 79% of those with death due to falls were over the age of 80, and 35% were 90 years or older. From 2020 to 2045, the observed and projected numbers of fall deaths were 2021 and 7073 for men (250% increase) and 3213 and 12 575 for women (291% increase).ConclusionMortality due to falls has increased in the past decades and will continue to rise sharply, mainly caused by growing numbers of older adults, especially those in their 80s and 90s. Contributing risk factors are well known, implementation of preventive measures is a much needed next step. An effective approach to managing elderly people after falls is warranted to reduce crowding in the emergency care and reduce unnecessary long hospital stays.

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Trends and projections in fall death in the Netherlands from 1990 to 2045

van der Naald,

Verbeek,

Baden

et al. 2024

Emerg Med J

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Strategies for implementation of a transmural fall-prevention care pathway for older adults with fall-related injuries at the emergency department

Charmant,

Snoeker,

van Hout

et al. 2024

BMC Emerg Med

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Background Although indicated, referrals for multifactorial fall risk assessments in older adults with fall related injuries presenting at the emergency department (ED) are not standard. The implementation of a transmural fall-prevention care pathway (TFCP) could bridge this gap by guiding patients to multifactorial fall risk assessments and personalised multidomain interventions in primary care. This study aims to develop and evaluate implementation strategies for a TFCP. Methods In this mixed-methods implementation study, strategies were developed using the Consolidated Framework for Implementation Research Expert Recommendations for Implementing Change Matching Tool. These were evaluated with patients, involved healthcare professionals, and other stakeholders using the Reach, Adoption, Implementation, and Maintenance of the RE-AIM framework in two cycles. Patients of the TFCP consisted of frail community dwelling individuals aged 65 and over presenting at the ED with fall related injuries. Results During the first implementation phase, strategies were focussed on assessing readiness, adaptability, local champions, incentives and education for all involved healthcare professions in the TFCP. Only 34.4% of eligible patients were informed of the TFCP at the ED, 30.6% agreed to a fall risk assessment and 8.3% patients received the fall risk assessment. In the second phase, this improved to 67.1%, 64.6%, and 35.4%, respectively. Strategies in this phase focussed on adaptability, obtaining sustainable financial resources, local champions, assessing readiness, and education. The implementation was facilitated by strategies related to awareness, champion recruitment, educational meetings, adaptability of TFCP elements and evaluations of facilitators and barriers. Conclusion The study outlined strategies for implementing TFCPs in EDs. Strategies included increasing awareness, utilising local champions, educational initiatives, adaptability of the TFCP, and continuous monitoring of facilitators and barriers. These insights can serve as a blueprint for enhancing fall prevention efforts for older adults in emergency department settings.

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Geriatric Falls: A Registry-Based Study in the Netherlands

Cited by 2 publications

References 24 publications

Trends and projections in fall death in the Netherlands from 1990 to 2045

Trends and projections in fall death in the Netherlands from 1990 to 2045

Strategies for implementation of a transmural fall-prevention care pathway for older adults with fall-related injuries at the emergency department

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