Physiotherapists Can Carry Out Assessments On Patients Using Falls Risk Assessment Tools

During hospitalizations, falls are amongst the highest preventable consistent adverse events. Preventing such undesirable events, enhances patient overall experience, as well as increased trust in the health care professional team (Fragata, 2011). The importance of fall prevention lies with the many serious unfavorable health outcomes it can pose on the patient. Falls have the potential increase length of hospital stay, limit mobility, independence, but can ultimately lead to health deterioration, including death. Worldwide, falls are the second leading cause of accidental death. In addition to the life-threatening health and safety risks falls have to the patient, it also as a financial impact,

Current literature has exposed many risk factors for falls. There are both intrinsic risk factors and extrinsic risk factors. Intrinsic risk factors include changes that come with age, such as gait issues, urinary incontinence, and fear of falling. Extrinsic risk factors include those that are related to the physical environment such as improper use of assistive devices and poor floor surfaces. No matter the type of risk factor, it is crucial to conduct a risk assessment when trying to prevent falls from occurring. Pearson and Coburn (2011) found that identifying risk factor for falls will help identify appropriate prevention strategies. Fall risk assessments help determine Talk about

Falls are a great health concern for hospitalized patients since it has been ranked the

Capan, K., & Lynch, B. (2007). Reports from the field: patient safety. a hospital fall assessment and intervention project. Journal of Clinical Outcomes Management: JCOM, 14(3), 155-160.

The widespread falls among the geriatric population reduce their quality of life and take away their functional independence. Lee et al (2013) state that falls leads to the rise in mortality rates and morbidity complications such as fractures and disabilities,1 out of 3 elderly persons in a community setting falls in a year. About 87% of all fractures in the elderly are due to falls. Several of the risk factors that are associated with falls are visual impairments, cognitive impairments, and health-related problems: arthritis, orthostatic, back pains, lack of balance-weakening muscles, previous falls, polypharmacy or psychoactive drugs (Lee et al, 2013).

A falls risk assessment is recommended as part of a routine medical examination for all older adults as well as for individuals with medical conditions that effect gait and balance. If you have a history of falls or or if you have been diagnosed with osteoporosis or fractures related to osteoporosis, it is imperative to speak to your healthcare provider about your personal risks for falling and about the fall prevention steps you should take to protect your bones.

The increase in patients falls and the number of patients that are fall risks has greatly increase. Part of this is due to the aging population. While there are many prevention methods in place, patients are continuing to experience falls. “Problem solving relies on decision-making, critical thinking, and/or clinical judgement” (Chamberlain College of Nursing, 2015). I recently had a patient that had two falls during his admission. I placed the patient on 1:1 observation. He was a fall risk due to his history, mental status, and medications (narcotic pain meds and antipsychotics). The patient did not fall again while I was at work. However, after my days off I came back and got report that the patient fell again. The patient had been taken

This project is part of an existing Quality Improvement Project by the organization on falls prevention, the most important aspect of a falls prevention initiative is using a standardized fall risk assessment (such as the BRIGGS Healthcare Falls Risk Assessment) to support the Quality Improvement Project. Quality Improvement projects are vital to any organization; they are data-driven, usually involve human participation. Also, it is a systematic approach, data-guided activities designed to bring about improvement in health delivery system. The fundamental obligation of health care providers and stakeholders are improving the quality of care of patients (Zaccagnini & White, 2011).

When asked to compare the policies of the clinical facility to that of the best-practice recommendations the following was revealed. First, the acute-care facility does utilize a fall risk assessment similar to that of the Morse fall scale. The patient is then identified as a fall risk one, two, or three. Based on the score, basic fall interventions are required. For example, a fall risk one requires safety rounds every two hours whereas a fall risk three require hourly safety

Townsend, Valle-Ortiz, and Sansweet (2016) article, “A Successful ED Fall Risk Program Using the Kinder 1 Fall Risk Assessment Tool” addresses an assessment tool for fall risk made for emergency department (ED) patients by ED nurses which was put into place upon arrival to the ED in Southern New Jersey. Patients who are aged 70 and up, mentally unstable, impaired mobility, or nursing judgement, they were labeled as high fall risk (Townsend et al., 2016). Townsend et al. (2016) continued by pointing out if any patient is at risk, fall precaution was enforced instantly, and the patient would receive a yellow band. Rounds per hour were also enforced.

Problem statement: According to Quality Improvement Organization Health Services Advisory Group, Alabama’s state average for falls without injury is 41.9% with the National average being slightly higher at 45%, falls with injury in Alabama is 3.2% with the National average being 3.4%. Research done by the Alzheimer’s Association (2016) has revealed that “People with dementia are at risk of falls because of their neurological impairments.” Another study completed by Esstmann discusses “The etiology of orthostatic hypotension should be investigated for older adults with known orthostatic

Fall risk assessments tools, which help to identify those patients at risk of falling, play a vital role in reducing the number of falls. The basis for this assessment is that if patients at high fall risk can be

Risk factors for falls are categorized by intrinsic or extrinsic (Tzeng, & Yin, 2009). According to Tzeng and Yin (2008), intrinsic factors, referring to the patient themselves, are related to their health status and possibly associated with age-related changes: previous falls, reduced vision, unsteady gait, musculoskeletal system deficits, mental status deficits, acute illness, and chronic illness. Extrinsic factors are involved in the patient’s environment, including medications, lack of support equipment, furniture, bathroom designs, small patient rooms, poor lighting, and improper use of and inadequate assistive devices. Tzeng & Yin (2008; 2009) focused on the extrinsic risk factors for the basis of their studies.

Internet Citation: Tool 3H: Morse Fall Scale for Identifying Fall Risk Factors. Content last reviewed January 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/fallpxtk-tool3h.html

Falling is inevitable at some point in life, and although most of the time falls are not serious, some can be life-threatening. Falls are a danger to both physical and psychological well-being because they may diminish a person’s ability to maintain an active and independent lifestyle.1 There are many factors that place individuals at risk for falls such as age, muscle weakness, difficulty with balance or walking, psychological diagnosis, and several medical conditions.1,2 Approximately one-third of people over the age of 65 fall at least once a year.3 Individuals that are status post stroke are at an increased risk of falls, making falls assessment and prevention a common priority for clinicians treating this population.1,2 Therefore, to direct the experimental methods and build on a basis of previous literature on this topic, the search began using OneSearch, CINAHL, PubMed, and