Preventing falls
Evidence and teamwork in Spanish primary care
Older adults living in the community face one of the most preventable causes of injury and loss of independence: falls. Yet despite strong evidence about how to identify and reduce fall risk, many health systems still struggle to translate that knowledge into day-to-day practice. A team of Spanish nurses decided to change that.
María García Fernández and colleagues from the Health Service of the Principality of Asturias set out to embed evidence-based fall assessment and prevention strategies in a primary health care centre serving both urban and rural populations in northern Spain. Supported by the Spanish Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, an evidence implementation project was developed and implemented, using the JBI Evidence Implementation Framework. The framework comprises clinical audit, feedback, and the Getting Research into Practice (GRiP) tool to close the gap between research and routine care.
Turning evidence into action
A baseline audit of 62 patients aged 70 years and older showed almost no documentation of fall history or risk assessment. There was zero compliance with best practice for seven of the eight audit criteria. The team identified five main barriers to compliance with best practice: the absence of screening tools and protocols; insufficient staff training; limited documentation fields in electronic health records; and high staff turnover.
Using the JBI framework, the project team developed practical strategies to address each gap, introducing a fall-risk assessment and intervention protocol, standardising documentation procedures, and delivering training for nurses on evidence-based screening and preventive care.
Measurable improvements
Following implementation of the strategies, compliance increased to as high as 100% across seven audit criteria, demonstrating a significant improvement in how consistently fall risk was assessed, recorded, and addressed. Nurses began to use validated tools such as the Timed Up and Go Test (TUGT), complete multifactorial risk assessments, and offer tailored interventions including home-based exercise programs, medication review, and fall-prevention education.
Moreover, the project strengthened collaboration among nurses, physicians, and regional health authorities, ensuring that falls are now recognised and managed as a shared responsibility within the community care system.
Building safer, age-friendly primary care
García Fernández and colleagues have shown that fall prevention in primary care can be both systematic and sustainable by embedding evidence into everyday workflows. Their approach not only improved documentation and early detection of risk but also fostered a proactive culture of falls prevention among staff.
As the authors conclude, combining structured audit, multidisciplinary teamwork, and continuous feedback can transform how primary care teams manage falls, protecting older adults’ safety, independence, and quality of life.
Read the full article in JBI Evidence Implementation, Volume 23, Issue 4 (2025):
Fall assessment and intervention among community-dwelling older people in a primary health care centre in Spain: a best practice implementation project.