Registered Nurses' Association of Ontario

Purpose and Scope

Best Practice Guidelines (BPGs) promote consistency and excellence in clinical care, health policies, and health education, ultimately leading to optimal health outcomes for people, communities, and the health-care system. This Guideline aims to outline evidence-based approaches for preventing falls and reducing fall injuries for adults.

This BPG replaces the RNAO (2011) BPG Prevention of Falls and Fall Injuries in the Older Adult, which was originally published in 2002 and then revised in 2005 and 2011.

The scope of the previous edition of this Guideline focused on older adults in hospital and long-term-care settings. This edition focuses on the prevention of falls and fall injuries in all adults (>18 years) at risk for falls and receiving care from nurses and other health-care providers across the health-care continuum, including those living in the community.


Application of This Guideline

Evidence reviewed for this Guideline included studies conducted in three main health-care settings: community (i.e., primary care, home care), hospital, and long-term care. Organizations and health-care providers are encouraged to critically review the recommendations and determine applicability within their practice settings and communities.

The systematic review demonstrated that the majority of evidence focused on older adults (adults 65 years and older). The general terms “person/people” or “adults” are used in the BPG rather than specifying interventions that apply to “older” or “younger” adults. However, RNAO suggests that health-care providers critically review the recommendations and determine applicability to young adults at risk for falls.

Intended Audience

Recommendations are provided at the following three levels:

  • Practice recommendations are directed primarily toward nurses who provide direct clinical care to adults at risk for falls across the continuum of care, including (but not limited to): primary care, home care, hospital care, and long-term care settings. The secondary audience of the practice recommendations includes other members of the interprofessional team who collaborate with nurses to provide comprehensive care. All of the recommendations are applicable to the scope of practice of registered nurses and nurse practitioners (general and extended classes); however, many are also applicable to other health-care providers.
  • Education recommendations are directed at individuals and organizations responsible for the education of health-care providers, such as educators, quality improvement teams, managers, administrators, academic institutions, and professional organizations.
  • Organization and policy recommendations are directed at those managers, administrators, and policy-makers responsible for developing policy or securing the supports required within health-care organizations that enable the implementation of best practices.

Topics Outside the Scope of This Guideline

The following topics are not covered in this Guideline:

  • population-level falls prevention strategies,
  • workplace/industry-related falls,
  • intentional falls,
  • sport-related falls,
  • falls among children (<18 years old), and
  • building environment or environmental design outside of settings specified for this Guideline (e.g., design of curbs and sidewalks in communities).
Older Adults
Preventing Falls and Reducing Injury from Falls
Background Information