Fall Prevention Activities Research Articles

Influencing Factors on Hospital Fall Prevention Activities of Tertiary Hospital Nurses and General Hospital Nurses

Objectives This study was aimed to identify influencing factors of hospital fall prevention activities of tertiary hospital nurses and general hospital nurses by examining relationships between knowledge and attitude of fall prevention, self-efficacy for preventing fall and perceived patient safety culture on fall prevention activities. Methods A total of 341 nurses from one university hospital and two general hospitals were recruited. A descriptive survey research was used with self administered questionnaires. Data were analyzed with descriptive statistics, t-test, ANOVA, Pearson correlation coefficients and multiple regression. Results As results of multiple regression analysis, the factors affecting hospital fall prevention activities of tertiary hospital nurses were working unit, working hours, knowledge of fall prevention, and self-efficacy for preventing fall. For general hospital nurses, the factors affecting hospital fall prevention activities were self-efficacy for preventing fall and perceived patient safety culture. Conclusions Based on the findings, there is a need to develop an intervention program for enhancing self-efficacy for preventing fall to improve fall prevention activities of nurses. Key words: Fall, Self-efficacy, Nurse, Patient safety culture

A risk-factor analysis of medical litigation judgments related to fall injuries in Korea.

The aim of this study was to find out the risk factors through analysis of seven medical malpractice judgments related to fall injuries. The risk factors were analysed by using the framework that approaches falls from a systems perspective and comprised people, organisational or environmental factors, with each factor being comprised of subfactors. The risk factors found in each of the seven judgments were aggregated into one framework. The risk factors related to patients (i.e. the people factor) were age, pain, related disease, activities and functional status, urination state, cognitive function impairment, past history of fall, blood transfusion, sleep endoscopy state and uncooperative attitude. The risk factors related to the medical staff and caregivers (i.e. people factor) were observation negligence, no fall prevention activities and negligence in managing high-risk group for fall. Organisational risk factors were a lack of workforce, a lack of training, neglecting the management of the high-risk group, neglecting the management of caregivers and the absence of a fall prevention procedure. Regarding the environment, the risk factors were found to be the emergency room, chairs without a backrest and the examination table. Identifying risk factors is essential for preventing fall accidents, since falls are preventable patient-safety incidents. Falls do not happen as a result of a single risk factor. Therefore, a systems approach is effective to identify risk factors, especially organisational and environmental factors.

Geriatric Hospital Nurses' Knowledge, Attitude toward Falls, and Fall Prevention Activities

Purpose Elders in hospital are at risk for falls. Thus, there is a need to identify geriatric hospital nurses' knowledge and attitude toward falls, and fall prevention activities, and factors which influence fall prevention activities. Methods Participants were 142 nurses from geriatric hospitals with more than 150 sick beds located in B city. Data were collected during August and September, 2012. The self-report questionnaires included questions on knowledge and attitude toward falls, and fall prevention activities. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression analysis with SPSS/WIN 21.0. Results Scores for knowledge, attitude and fall prevention activities were relatively high. In the relationships between knowledge, attitudes and fall prevention activities, knowledge about falls had no correlation with attitude or prevention activities, but a correlation was found between attitude and fall prevention activities. Factors influencing fall prevention activities were attitude toward falls (β=.34, p<.001), age (β=.21, p=.008) and having received fall prevention education (β=.15, p=.044). Conclusion Findings indicate that there is a need to implement education programs to improve nurses' attitude toward falls and fall prevention, and provide opportunities for frequent fall prevention training and education to increase the practice of fall prevention activities. 주요어: 지식, 태도, ë‚™ìƒì‚¬ê³ , ì‚¬ê³ ì˜ˆë°©, ë ¸ì¸ê°„í˜¸ Key Words: Knowledge, Attitude, Accidental falls, Accident prevention, Geriatric nursing

Falls prevention activities among community-dwelling elderly in the Netherlands: A Delphi study

IntroductionThis study aimed to provide an overview of the current falls prevention activities in community-dwelling elderly with an increased risk of falling in the Netherlands. Therefore, we determined: a) how health professionals detect community-dwelling elderly with an increased risk of falling; b) which falls prevention activities are used by health professionals and why; c) how elderly can be stimulated to participate in falls prevention programs; and d) how to finance falls prevention. MethodsA two-round online Delphi study among health experts was conducted. The panel of experts (n=125) consisted of community physiotherapists, community nurses, general practitioners, occupational therapists and geriatricians, from all over the Netherlands. The median and Inter Quartile Deviation (IQD) were reported for the questions with 5-point Likert scales, ranging from ‘least’ (1) to ‘most’ (5). ResultsRespectively 68% (n=85/125) and 58% (n=72/125) of the panel completely filled in the first and second round questionnaires. According to the panel, regular detection of fall risk of community-dwelling elderly with an increased risk of falling hardly takes place (median=2 [hardly]; IQD=1). Furthermore, these elderly are reluctant to participate in annual detection of fall risk (median=3 [reluctant]; IQD=1). According to 73% (n=37/51) of the panel, 0–40% of the elderly with an increased risk of falling are referred to exercise programs. In general, the panel indicated that structural follow-up is often lacking. Namely, after one month (n=21/43; 49%), three months (n=24/42; 57%), and six months (n=27/45; 60%) follow-up is never or hardly ever offered. Participation of elderly in falls prevention programs could be stimulated by a combination of measures. Should a combination of national health education, healthcare counseling, and removal of financial barriers be applied, 41–80% of the elderly is assumed to participate in falls prevention programs (n=47/64; 73%). None of the panel members indicated full financing of falls prevention by the elderly. A number of individuals are considered key in falls prevention activities, such as the general practitioner, physiotherapist, and informal caregiver. ConclusionThis Delphi study showed clear directions for improving falls prevention activities and how to increase participation rates.

Older adult falls prevention behaviors 60 days post-discharge from an urban emergency department after treatment for a fall

BackgroundFalls are a common and debilitating health problem for older adults. Older adults are often treated and discharged home by emergency department (ED)-based providers with the hope they will receive falls prevention resources and referrals from their primary care provider. This descriptive study investigated falls prevention activities, including interactions with primary care providers, among community-dwelling older adults who were discharged home after presenting to an ED with a fall-related injury.MethodsWe enrolled English speaking patients, aged ≥ 65 years, who presented to the ED of an urban level one trauma center with a fall or fall related injury and discharged home. During subjects’ initial visits to the ED, we screened and enrolled patients, gathered patient demographics and provided them with a flyer for a Matter of Balance course. Sixty-days post enrollment, we conducted a phone follow-up interview to collect information on post-fall behaviors including information regarding the efforts to engage family and the primary care provider, enroll in a falls prevention program, assess patients’ attitudes towards falling and experiences with any subsequent falls.ResultsEighty-seven community-dwelling people between the ages of 65 and 90 were recruited, the majority (76%) being women. Seventy-one percent of subjects reported talking to their provider regarding the fall; 37% reported engaging in falls prevention activities. No subjects reported enrolling in a fall prevention program although two reported contacting falls program staff. Fourteen percent of subjects (n=12) reported a recurrent fall and 8% (7) reported returning to the ED after a recurrent fall.ConclusionsFindings indicate a low rate of initiating fall prevention behaviors following an ED visit for a fall-related injury among community-dwelling older adults, and highlight the ED visit as an important, but underutilized, opportunity to mobilize health care resources for people at high risk for subsequent falls.

Study of Individualization and Bias in Nursing Home Fall Prevention Practices.

Little is known about how nursing home staff use resident characteristics to individualize care delivery or whether care is affected by implicit bias. Randomized factorial clinical vignette survey. Sixteen nursing homes in North Carolina. Nursing, rehabilitation, and social services staff (n = 433). Vignettes describing hypothetical residents were generated from a matrix of clinical and demographic characteristics. Resident age, race and gender were suggested by a photo. Participants completed up to four randomly assigned vignettes (n = 1615), rating the likelihood that 12 fall prevention activities would be used for the resident. Fixed and random effects mixed model analysis examined the impact of vignette resident characteristics and staff characteristics on four intervention categories. Staff reported a higher likelihood of fall prevention activities in all four categories for residents with a prior fall (0.2-0.5 points higher, 10 point scale, P < 0.05), but other risk factors did not affect scores. There was little evidence of individualization; only dementia increased the reported likelihood of environmental modification (0.3, P < 0.001, 95% CI 0.2-0.5). Individualization did not vary with staff licensure category or clinical experience. Registered nurses consistently reported higher likelihoods of all fall prevention activities than did licensed practical nurses, unlicensed staff and other professional staff (1.0-2.7 points, P < 0.001 to 0.005). There was a small degree of implicit racial bias; staff indicated that environmental modification would be less likely to occur in otherwise identical vignettes including a photo of a black rather than a white resident (-0.2 points, 95% CI -0.3 to -0.1). Nursing home staff report a standardized approach to fall prevention without individualization. We found a small impact from implicit racial bias that should be further explored.

Can a web-based community of practice be established and operated to lead falls prevention activity in residential care?

The aims of this study were to evaluate establishing and operating a web-based community of practice (CoP) to lead falls prevention in a residential aged care (RAC) setting. A mixed methods evaluation was conducted in two phases using a survey and transcripts from interactive electronic sources. Nurses and allied health staff (n = 20) with an interest in falls prevention representing 13 sites of an RAC organization participated. In Phase 1, the CoP was developed, and the establishment of its structure and composition was evaluated using determinants of success reported in the literature. In Phase 2, all participants interacted using the web, but frequency of engagement by any participant was low. Participatory barriers, including competing demands from other tasks and low levels of knowledge about information communication technology (ICT) applications, were identified by CoP members. A web-based CoP can be established and operated across multiple RAC sites if RAC management support dedicated time for web-based participation and staff are given web-based training.

FALL PREVENTION PRIMER FOR THE PRIMARY CARE PRACTIONER:

&lt;p&gt;&lt;strong&gt;ABSTRACT:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;One of three older adults age 65+ fall each year, and every 20 minutes an older adult dies due to injuries sustained during a fall. Yet, most patients do not report falls to their physician. Primary care practitioners (PCPs) are well positioned to screen for fall risk and add proactive referral patterns to both well-selected practitioners and evidence-based fall prevention (EBFP) programs designed to help older patients stay healthy, active, and independent.&lt;/p&gt;&lt;p&gt;The purposes of this review are to summarize the data related to the impact of falls; review efficient and reliable screening tools that identify individuals at high fall risk; describe appropriate referrals that facilitate a match between individual specific risk factors and interventions; and, highlight evidence-based fall prevention (EBFP) programs available to significantly decrease fall risk with outstanding return on investment.&lt;/p&gt;&lt;p&gt;Simple administrative changes in a PCP’s practice accompanied by appropriate referrals will result in proactive fall prevention including lower rates of falls and fall injuries and fewer hospitalizations and/or hospital readmissions. Fall risk screening can be built into practice to seamlessly add services without impacting practitioner productivity. Additionally, reporting fall risk screening and prevention activities in the Physician Quality Reporting System will positively impact practice Medicare reimbursement rates.&lt;/p&gt;

The Affect Factors of Geriatric Hospital Nurse’s Falls Prevention Activities

Objectives: The purpose of this study was to understand the relation among fall knowledge, fall attitude, nursing environment and fall prevention activities in nurses who work at geriatric hospitals, and identify factors which affect on fall prevention activities. Methods: Using the convenient sampling method, the data were collected from nurses who had been working at 16 geriatric hospitals in D Metropolitan City for longer than three months. The collected data from 210 nurses were analyzed using descriptive statistics, independent t-test, one-way ANOVA with Scheffė test and multiple regression with SPSS/WIN 20.0. Results: Subjects’ fall knowledge and fall attitude turned out to work as relatively high influence factors. They perceived nursing practice environment as positive and highly involved in fall prevention activities as well. Geriatric hospital nurses who were older, married, paid better, more experienced in clinical environment and learned more about fall-related education were better at fall prevention activities. Fall prevention activities were significantly related to fall attitude and nursing practice environment. Under the control of individual characteristics among geriatric hospital nurses, Hierarchial Linear Regression revealed that fall attitude, wage and fall education hours worked as positive influence factors, however, nursing practice environment did not affect much. Explanation power of the variables were 30.4%. Conclusions: Based on the result of the study, an education program with sufficient hours to change nurses’ fall attitude needs to be developed, and a plan which will bring positive change in nursing practice environment needs to be sought to improve geriatric hospital nurses’ fall prevention activities. Key words: Accidental falls, Practice environment, Accident prevention

Using a community of practice to evaluate falls prevention activity in a residential aged care organisation: a clinical audit.

Objective This study evaluates whether a community of practice (CoP) could conduct a falls prevention clinical audit and identify gaps in falls prevention practice requiring action. Methods Cross-sectional falls prevention clinical audits were conducted in 13 residential aged care (RAC) sites of a not-for-profit organisation providing care to a total of 779 residents. The audits were led by an operationalised CoP assisted by site clinical staff. A CoP is a group of people with a shared interest who get together to innovate for change. The CoP was made up of self-nominated staff representing all RAC sites and comprised of staff from various disciplines with a shared interest in falls prevention. Results All 13 (100%) sites completed the audit. CoP conduct of the audit met identified criteria for an effective clinical audit. The priorities for improvement were identified as increasing the proportion of residents receiving vitamin D supplementation (mean 41.5%, s.d. 23.7) and development of mandatory falls prevention education for staff and a falls prevention policy, as neither was in place at any site. CoP actions undertaken included a letter to visiting GPs requesting support for vitamin D prescription, surveys of care staff and residents to inform falls education development, defining falls and writing a falls prevention policy. Conclusion A CoP was able to effectively conduct an evidence-based falls prevention activity audit and identify gaps in practice. CoP members were well positioned, as site staff, to overcome barriers and facilitate action in falls prevention practice. What is known about the topic? Audit and feedback is an effective way of measuring clinical quality and safety. CoPs have been established in healthcare using workplace staff to address clinical problems but little is known about their ability to audit and influence practice change. What does this paper add? This study contributes to the body of knowledge on CoPs in healthcare by evaluating the performance of one in the domain of falls prevention audit action. What are the implications for practitioners? A CoP is an effective model to engage staff in the clinical audit process. Clinical audits can raise staff awareness of gaps in practice and motivate staff to plan and action change as recommended in best practice guidelines.

Developing networks between residential aged care facilities as a result of engagement in a falls prevention project: an action research study

Background: Residential aged care facility (RACF) staff often operate in isolation. Research is lacking on networking between facilities. Aims: To explore outcomes associated with network formation between two RACFs as part of an action research approach to reducing falls. Design: Action research approach with qualitative data collected. Methods: Twelve RACF staff from two facilities in regional Tasmania, Australia, formed a falls prevention action research group. Thematic analysis was undertaken of 22 audio-recorded fortnightly group meetings. Results: This was the first opportunity for participants to meet colleagues from another facility in a professional context. The formation of an inter-facility network enabled the sharing of ideas and systems related to evidence-based falls prevention activities and other issues and galvanised a collaborative focus for action. Conclusions: An action research process can be used to create an inter-facility network. Such networks can decrease staff isolation and facilitate best resident care.

Patient Safety Culture, Attitude Toward Falls, and Fall Prevention Activities of Care Workers in Long-term Care Facilities

Purpose: The aim of this study was to provide basic data for the improvement of patient safety by investigating the relationship among patient safety culture, attitude toward falls, and fall prevention activities of care workers in long-term care facilities. Methods: This study was a descriptive correlational research. Data were collected between August 9 and October 2, 2014 from 190 care workers in long-term care facilities in G, S, and W cities. A structured questionnaire which included patient safety culture, attitude toward falls, and fall prevention activities was used for data collection. Results: There were positive correlations between patient safety culture and attitude toward falls, and between patient safety culture and fall prevention activities. There was a statistically significant positive correlation between attitude toward falls and fall prevention activities. A more positive evaluation of level of safety management correlated with a positive attitude toward falls and high practice of fall prevention activities. Conclusion: Findings indicate that considering care workers’ careers, nurses should enhance patient safety education and establish a system that objectively evaluates patient safety management activity including fall prevention activities. 주요어: 요양기관, 요양보호사, í™˜ìžì•ˆì „, 낙상, 예방활동 Key Words: Nursing homes, Caregivers, Patient safety, Accidental falls, Accident prevention

Investigating the impact of a falls prevention community of practice in a residential aged-care setting: a mixed methods study protocol.

The aim of this study was to facilitate the implementation and operation of a falls prevention Community of Practice in a residential aged-care organization and evaluate its effect on falls outcomes. Falls are a substantial concern across the residential aged-care sector with half its older population falling annually. Preventing falls requires tailoring of current evidence for reducing falls and adoption into daily activity, which is challenging for diversely skilled staff caring for a frailer population. Forming a community of practice could provide staff with the opportunity to share and develop their expertise in falls prevention and innovate change. A mixed methods design based on a realist approach conducted across 13 residential care facilities (N=779 beds). Staff will be invited to become a member of the community of practice with all sites represented. The community of practice will be supported to audit falls prevention activity and identify gaps in practice for intervention. The impact of the community of practice will be evaluated at three levels: individual member level, facility level and organizational level. A pre-post design using a range of standardized measures supported by audits, surveys, focus groups and interviews will determine its effect on falls prevention practice. Falls outcomes will be compared at five time intervals using negative binomial regression and logistic regression. The study is funded 2013-2017. Findings from this research will assist residential aged-care providers to understand how to effectively translate evidence about falls prevention into clinical practice.

Engaging community organizations in falls prevention for older adults: Moving from research to action.

Falls prevention (FP) evidence abounds but falls rates remain relatively unaffected. This study aimed to explore community service providers' use of evidence-based FP interventions, attitudes toward implementation, knowledge and capacity for FP engagement, collaboration in FP, and organizational readiness to implement evidence. To our knowledge, this is the first study exploring the potential for broader integration of FP throughout communities. A purposive sampling of providers (n = 84), in varied roles within diverse senior-serving community organizations (both health and non-health sectors) across disparate geographies, completed a structured survey as part of a larger mixed methods study. Nearly all (90%) reported already implementing at least one evidence-based FP practice. The majority indicated that falls were preventable (82%) and a top concern for older adults (75%), and that FP would be beneficial to their clients (75%). There were, however, notable differences between health and non-health sectors in their: confidence in providing FP activities (86% vs. 47%), desire for future collaboration (86% vs. 56%) and already knowing how best to provide FP activities (49% vs. 36%). Only some (21%) perceived that staff to a great extent had the necessary knowledge and skills, and few (10%) perceived that available resources could support FP activities. Community service providers generally supported FP, but resources limited implementation, particularly in non-health sectors. Translating FP evidence to better fit community settings, and fostering collaboration to bridge resource gaps, suggest a public health role in the broader integration of FP within and across community sectors.

An Introduction to the Centers for Disease Control and Prevention's Efforts to Prevent Older Adult Falls.

An Introduction to the Centers for Disease Control and Prevention's Efforts to Prevent Older Adult Falls.

Falling for a balance partner.

The growing accumulation of knowledge about fall prevention strategies primarily reflects a research perspective where intervention data are rigorously collected and analyzed. However, the voices of program deliverers or participants who are part of these interventions are often aggregated and thus muted. With recognition of the growing importance of patient-centered care, we wanted to provide a personal reflection on the Balance Partner program, a CDC funded project to train peer leaders in fall prevention. In the story below, Sara was trained as a Balance Partner using a curriculum developed at The University of North Carolina’s Center for Health Promotion and Disease Prevention. The Balance Partner Program provides training and support to community volunteers who are paired with a peer who is at risk for falls. Together, Balance Partners plan strategies to decrease the likelihood of a fall – strategies that could include joining a balance exercise program, improving home safety, or getting a vision check-up. By addressing social and emotional factors alongside knowledge about falls, the Balance Partner Program aims to increase older adults’ overall adherence to fall prevention activities above the 50% rate reported in literature (1). Sara, a 69-year-old volunteer, was paired with Georgia, who screened at high risk for falls during a Building Better Balance Screening in Asheville, NC, USA. As of this writing, Sara and Georgia had worked together for almost 6 months to implement strategies to reduce their falls risk.

Determinants of uptake of home modifications and exercise to prevent falls in community‐dwelling older people

ObjectiveTo examine the age‐specific population prevalence and predictors of uptake of home modifications and exercise to prevent falls in the NSW older population. MethodsA total of 5,681 respondents were asked questions on fall prevention activities as part of the 2009 NSW Falls Prevention Survey. Results were weighted to represent the NSW population. Regression analysis was used to determine factors associated with uptake of interventions. ResultsOverall, 28.9% of the older population have modified their home, and 35.1% increased exercise to prevent falls. Main predictors of home modification were being aged 85+ (RR 2.04, 95% CI 1.76–2.35) and physiotherapy/occupational therapy intervention (RR 1.57, 95% CI 1.22–2.01). Main predictors of increasing exercise were physiotherapy/OT intervention (RR 2.12, 95% CI 1.86–2.42) and medical advice (RR 1.45, 95% CI1.32–1.60). Older respondents (RR 0.68, 95% CI 0.57–0.81) and those with fair/poor health (RR 0.86, 95% CI 0.77–0.96) were less likely to report increased exercise. ConclusionMore than one‐quarter of the older population of NSW report having made modifications to their home and one‐third increased exercise to prevent falls. There was a clear gradient of increased uptake of home modifications with increasing age, with the reverse trend for increased exercise. ImplicationAlthough fall prevention initiatives are having an impact at the population level, targeted strategies for high‐risk groups are still required.

Aktivnosti za preprečevanje padcev v rehabilitaciji pacientov po možganski kapi in njihov učinek na incidenco padcev

Uvod: Preprečevanje padcev je pomemben del rehabilitacijske obravnave. S timsko obravnavo in sistematičnim izvajanjem aktivnosti pri za padec visoko ogroženih pacientih se število padcev lahko zmanjša. Metode: V raziskavo je bilo vključenih 1.634 pacientov na rehabilitaciji po možganski kapi v Univerzitetnem rehabilitacijskem inštitutu Republike Slovenije – Soča (URI – Soča) od 1. 1. 2007 do 31. 12. 2012. Za ugotavljanje učinkovitosti aktivnosti za preprečevanje padcev pacientov je bila izvedena retrospektivna opazovalna raziskava z elementi akcijskega raziskovanja. Uspešnost izvedenih aktivnosti za preprečevanje padcev se je ugotavljala na podlagi incidence padcev. Rezultati: V primerjavi z obdobjem 2007 do 2010, ko so se izvajale splošne aktivnosti za preprečevanje padcev in je incidenca padcev npr. leta 2007 znašala 4,5/1000 bolnišničnooskrbnih dni, se je le-ta v letih 2011 in 2012 po uvedbi lestvice za oceno tveganja za padec ter sistematičnega delovanja celotnega rehabilitacijskega tima pomembno zmanjšala, tako da je leta 2012 znašala 2,8/1000 bolnišničnooskrbnih dni. Učinkovitost sistematičnega delovanja pri preprečevanju padcev se kaže v manjšem številu pacientov, ki so padli enkrat (p = 0,025). Diskusija in zaključek: S sistematičnim delovanjem multidisciplinarnega rehabilitacijskega tima lahko učinkovito zmanjšamo število padcev pacientov po možganski kapi na rehabilitacijskem oddelku. Vpliv teh aktivnosti na preprečevanje padcev pacientov v domačem okolju po zaključeni rehabilitaciji odpira tudi možnosti za nadaljnje raziskovalno delo.

The meaning of the experience of anticipating falling

ABSTRACTFalling in later life continues to be a critical issue in gerontology research, health professional practice and ageing health policy. However, much research in the area of fall risk and fall prevention neglects the meaning of the experiences of older people themselves. This humanistic interpretive phenomenological study explored the meaning of the experience of anticipating falling from the perspective of older people in order to foster a more person-focused approach to fall risk assessment and fall prevention. Individual semi-structured interviews were conducted with nine participants over the age of 65 living independently in the community. Follow-up interviews with two key informants were completed to inform the emerging interpretations. For older participants residing in the community, the experience of anticipating falling meant confronting their embodied lived-identity in the context of ageing. Experiential learning shaped how participants understood the meaning of falling, which constituted tacit, pathic knowledge of vulnerability and anxiety with respect to falling. Findings emphasise the importance of critically reflecting on the social experience of anticipating falling to develop effective and relevant fall prevention interventions, programmes and policies. A lifeworld-led approach to fall risk assessment and fall prevention resonates with these findings, and may encourage health-care providers to adopt a sustained focus on embodied lived-identity and quality of life when engaging older people in fall prevention activities.

RESPOND--A patient-centred programme to prevent secondary falls in older people presenting to the emergency department with a fall: protocol for a multicentre randomised controlled trial.

Participation in falls prevention activities by older people following presentation to the emergency department (ED) with a fall is suboptimal. This randomised controlled trial (RCT) will test the RESPOND programme, an intervention designed to improve older persons' participation in falls prevention activities through delivery of patient-centred education and behaviour change strategies. A RCT at two tertiary referral EDs in Melbourne and Perth, Australia. 528 community-dwelling people aged 60-90 years presenting to the ED with a fall and discharged home will be recruited. People who require an interpreter or hands-on assistance to walk; live in residential aged care or >50 km from the trial hospital; have terminal illness, cognitive impairment, documented aggressive behaviour or a history of psychosis; are receiving palliative care or are unable to use a telephone will be excluded. Participants will be randomly allocated to the RESPOND intervention or standard care control group. RESPOND incorporates (1) a home-based risk factor assessment; (2) education, coaching, goal setting and follow-up telephone support for management of one or more of four risk factors with evidence of effective interventions and (3) healthcare provider communication and community linkage delivered over 6 months. Primary outcomes are falls and fall injuries per person-year. RESPOND builds on prior falls prevention learnings and aims to help individuals make guided decisions about how they will manage their falls risk. Patient-centred models have been successfully trialled in chronic and cardiovascular disease; however, evidence to support this approach in falls prevention is limited. The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000336684).