This clinical guideline provides evidence and recommendations on the assessment and prevention of falls in older people. It extends and replaces ‘Falls: assessment and prevention of falls in older people’ (NICE clinical guideline 21; 2004), by including additional recommendations about preventing falls in people admitted to hospital (inpatients).

This document includes all the recommendations, details of how they were developed and summaries of the evidence they were based on.

This guideline has been developed following the methods and processes outlined in the ‘NICE guidelines manual’ (2009).

Contents

• Introduction
• Patient-centred care
• Strength of recommendations
• Key priorities for implementation
• 1. Recommendations
  • 1.1. Preventing falls in older people
  • 1.2. Preventing falls in older people during a hospital stay
• 2. Care pathway
• 3. The assessment and prevention of falls in older people
  • Disclaimer
  • 3.1. Executive summary
  • 3.2. Aims
  • 3.3. Methods
  • 3.4. Guideline recommendations with supporting evidence reviews
  • 3.5. Recommendations for research
  • 3.6. Validation
• 4. Assessment and prevention of falls in older people during a hospital stay
  • 4.1. Background
  • 4.2. Methods used to develop this part of guideline
  • 4.3. Inpatient risk prediction : evidence review and recommendations
  • 4.4. Inpatient falls prevention interventions: evidence review and recommendations
  • 4.5. Inpatient information: evidence review and recommendations
  • 4.6. List of research recommendations
• 5. Further information
  • 5.1. Guideline development group information
  • 5.2. Notes on the scope of the guideline
  • 5.3. Implementation
  • 5.4. Other versions of this guideline
  • 5.5. Related NICE guidance
  • 5.6. References
  • 5.7. Glossary and abbreviations
• Appendix A. 2013 Guideline Development Group membership and acknowledgements
• Appendix B. 2013 Medline search strategies for the Falls guideline
• Appendix C. 2013 Quality check list
• Appendix D. 2013 List of Stakeholders
• Appendix E. 2013 Review protocols and evidence tables
• Appendix F. Quality assessment of trials (2004)
• Appendix G. Excluded studies
• Appendix H. Meta-analysis figures (2004)
• Appendix I. Scope and clinical review questions
• Appendix J. How this guideline was developed
• Appendix K. Full Health Economic Report
• Appendix L. Deleted text from Section 4

NICE clinical guidelines are recommendations about the treatment and care of people with specific diseases and conditions in the NHS in England and Wales.

This guidance represents the view of NICE, which was arrived at after careful consideration of the evidence available. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, and informed by the summary of product characteristics of any drugs.

Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.