Perceptions of Family Physicians About Fall Risk Screening, Fall Risk Assessment, and Referral Practices for Fall Prevention in Malaysia

2020 ◽  
Vol 36 (1) ◽  
pp. 38-43
Author(s):  
Mohamad Hasif Jaafar ◽  
Sumaiyah Mat ◽  
Lynette Mackenzie ◽  
Maw Pin Tan
Keyword(s):  
Risk Assessment ◽  
Fall Prevention ◽  
Fall Risk ◽  
Family Physicians ◽  
Risk Screening ◽  
Fall Risk Assessment ◽  
Referral Practices ◽  
Fall Risk Screening

To Assess the Fall Risk among the Elderly in selected Urban Area Kachery, Thrissur

2021 ◽  
pp. 295-298
Author(s):  
Ann Mariya P.R ◽  
Delna Mary George ◽  
Elsamol Francis ◽  
Thasni R.A ◽  
Twinkle Joseph ◽  
...  
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Urban Area ◽  
Elderly People ◽  
Fall Prevention ◽  
Fall Risk ◽  
Elderly Person ◽  
The Elderly ◽  
Previous Knowledge ◽  
Fall Risk Assessment

To assess the fall of risk among the elderly in selected urban area of Thrissur. Objectives a) To assess the fall risk among the elderly people in selected urban area of Kachery, Thrissur. b) To associate fall risk score with selected demographic variables. c) To correlate fall risk assessment questionnaire score and modified fall prevention checklist for personal risk factors score among elderly individuals. d) To teach the elderly people about fall prevention exercise. Methodology: Non-experimental descriptive research design is adopted in this study. We selected 60 samples through random sampling technique. Standardized fall risk assessment questionnaire built by national aging research institute and modified fall prevention checklist for personal risk factors built by Hamilton county was used to collect the data. Tool was administered by interview method for assessing fall risk. Fall preventive intervention module developed, validated and administered following data collection. The data collected were analyzed by using descriptive and inferential statistics. Result: The demographic profile of elderly people shows that 46.66% belongs to age group between 60-70 years and most of them 58.33% were females. The majority 73.33% of elderly person are at low risk for fall and 26.66% are at high risk for fall in questionnaire and 81.67% of elderly are low risk for fall, 18.33% are risk and there is no elderly person high risk for fall in checklist. The overall fall risk is high among elderly individual alone in home and low in elderly in nuclear families. The risk for fall among elderly based on previous history of fall shows that elderly with visual impairment those who don’t have previous knowledge about fall prevention and elderly age between 91-100 is high risk for fall. The risk for fall based on ability to perform ADL in elderly shows those who living alone in the home high risk for fall. There is significant association between score with selected variables like age, previous knowledge about fall prevention, elderly residing in their home alone. We found that there is perfect positive correlation r=1 between fall risk assessment, questionnaires and checklist score. Discussion: At the end of the study the investigator found that the risk for fall based on the assessment of fall history among elderly people shows that, there is significant association between age (p=0.0273) that is, age group between 91-100 years are high risk for fall. Previous knowledge about fall prevention shows that, elderly without previous knowledge about fall prevention is at high risk for fall (p= 0.03074). In sensory impairment that is, elderly having visual impairment (p=0.998) having risk for fall. The risk for fall among elderly people based on their ability to perform activities of daily living shows that, elderly residing in their home alone shows more risk for fall.

scholarly journals Predicting Falls Risk in Hospital; KPJ Seremban Experience

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Maygala A ◽  
Primuhasa Putra SHA ◽  
Aziz AR ◽  
Ainol MR ◽  
Zainah J ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Patient Safety ◽  
Fall Prevention ◽  
Fall Risk ◽  
Assessment Tool ◽  
Healthcare Providers ◽  
Extended Period ◽  
Risk Assessment Tool ◽  
Contributing Factors ◽  
Fall Risk Assessment

Introduction: Falls may result in injuries, prolonged hospitalization, increase in morbidity and mortality, incur cost to the individual and the healthcare system and increase potential litigation. Various hospital fall prevention programs such as Morse Fall Scale Assessment Tool have been implemented in the last decade; however most of the program had no sustained effects on falls reduction over extended period of time. Benchmarking from private hospitals showed patients fall increased by 27% in 2008 as compared to 2007 (MPC report, 2008). There were 25 cases of falls in 2008 at KPJ Seremban Specialist Hospital. The objective of this program is to comply with The Joint Commission’s National Patient Safety Goals 9, “reduce the risk of patient harm resulting from falls” and to formulate evidence based best clinical practice recommendations on assessment and prevention of falls in the hospital for all inpatients, outpatients, customers and staffs within hospital premises. Materials and Methods: Contributing factors were identified based on the retrospective analysis of falls from 1st.January 2008 to 30th September 2008. A fall risk assessment tool identified as KPJ FRAT (KPJ Fall Risk Assessment Tool) for inpatient was developed and various other strategies to reduce the risk of falls throughout the hospital premises were identified. Points of engagement for inpatient assessment using KPJ FRAT were on admission, transfer in or when there is a change in patients’ condition. A prospective descriptive study was done and data was collected from 1st January 2009 till 31st December 2009 through interview with patients, healthcare providers and review of adverse event reports and medical records. Results: No of inpatients during this study were 37058 and there were 13 falls. The post implementation data reflects for every 1000 inpatient days the fall rate decreased to 4.3 falls. Conclusion: The use of KPJ FRAT and Fall Prevention program implemented throughout KPJ SSH has reduced the incidence of falls significantly by 48%. This might be due to increase awareness among the staff, hospital wide policy to report all cases and the formation of patient safety committee to formulate policy and reinforce the implementation processes. Limitation of the study include under reporting and heavy workload.

scholarly journals ABILITY OF THE PHYSIOLOGICAL PROFILE ASSESSMENT TO CLASSIFY FALLER TYPE: A PROSPECTIVE COHORT STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S471-S471
Author(s):  
Deborah A Jehu ◽  
Jennifer C Davis ◽  
Kristin Velsey ◽  
Winnie Cheung ◽  
Teresa Liu-Ambrose
Keyword(s):  
Older Adults ◽  
Risk Assessment ◽  
Fall Prevention ◽  
Fall Risk ◽  
Vancouver General Hospital ◽  
Community Dwelling ◽  
Medical Attention ◽  
Physiological Profile ◽  
Fall Risk Assessment ◽  
Physiological Profile Assessment

Abstract Accurately identifying older adults who will experience subsequent falls is important for the provision of secondary fall prevention. The purpose of this study was to determine the accuracy of the Physiological Profile Assessment (PPA) – a valid and reliable fall-risk assessment [1] – in predicting subsequent falls over a 12-month period in older adults who sought for medical attention after an index fall. Seven hundred thirty-seven community-dwelling adults, aged 70 years and older, who were seen at the Vancouver General Hospital Fall Prevention Clinic, completed the PPA at their initial visit. Falls over the subsequent 12 months were tracked prospectively via monthly falls calendars. All individuals received geriatric care at baseline. Binary logistic regressions were performed to determine the accuracy of classifying two prospective faller types: 1) no additional falls; 2) one or more additional fall(s). Baseline PPA, age, and sex were entered as independent variables. During the 12 month observation period, 345 participants had no additional falls (Age:81.3±6.6yrs;Female=251) and 392 fell one or more times (Age:82.3±6.5yrs;Female=230). The classification accuracy was 51.3% for those who had no additional falls and 64.8% for those with one or more additional fall(s) (Overall:58.5%;χ2=29.0;PPA:β=-0.21;Age:β=-0.01;Sex:β=-60). The PPA was not able to accurately differentiate between those who did and did not subsequently fall. Fall-risk assessment sensitivity and specificity should be improved in older adults seeking medical attention following an index fall to inform secondary fall prevention. [1] Lord SR, et al., 2003. Phys Ther.

scholarly journals Implementing a Clinically Based Fall Prevention Program

2017 ◽  
Vol 14 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Judy A. Stevens ◽  
Matthew Lee Smith ◽  
Erin M. Parker ◽  
Luohua Jiang ◽  
Frank D. Floyd
Keyword(s):  
Primary Care ◽  
Staff Training ◽  
Fall Prevention ◽  
Fall Risk ◽  
New York State ◽  
Primary Care Providers ◽  
York State Department ◽  
Care Providers ◽  
Risk Screening ◽  
Fall Risk Screening

Introduction. Among people aged 65 and older, falls are the leading cause of both fatal and nonfatal injuries. The burden of falls is expected to increase as the US population ages. The Centers for Disease Control and Prevention (CDC) developed the STEADI (Stopping Elderly Accidents, Deaths, and Injuries) initiative to help primary care providers incorporate fall risk screening, assessment of patients’ modifiable risk factors, and implementation of evidence-based treatment strategies. Methods. In 2010, CDC funded the New York State Department of Health to implement STEADI in primary care sites in selected communities. The Medical Director of United Health Services championed integrating fall prevention into clinical practice and oversaw staff training. Components of STEADI were integrated into the health system’s electronic health record (EHR), and fall risk screening questions were added to the nursing staff’s patient intake forms. Results. In the first 12 months, 14 practices saw 10 702 patients aged 65 and older. Of these, 8457 patients (79.0%) were screened for fall risk and 1534 (18.1%) screened positive. About 52% of positive patients completed the Timed Up and Go gait and balance assessment. Screening declined to 49% in the second 12 months, with 21% of the patients screening positive. Conclusions. Fall prevention can be successfully integrated into primary care when it is supported by a clinical champion, coupled with timely staff training/retraining, incorporated into the EHR, and adapted to fit into the practice workflow.

scholarly journals A modelling-based economic evaluation of primary-care-based fall-risk screening followed by fall-prevention intervention: a cohort-based Markov model stratified by older age groups

2019 ◽  
Vol 49 (1) ◽  
pp. 57-66 ◽  
Author(s):  
Matthew Franklin ◽  
Rachael Maree Hunter
Keyword(s):  
Risk Assessment ◽  
Cost Effectiveness ◽  
Fall Prevention ◽  
Fall Risk ◽  
Care Pathway ◽  
Cost Effective ◽  
Older Age ◽  
Fall Risk Assessment ◽  
Prevention Intervention ◽  
Fall Prevention Intervention

Abstract Background fall-risk assessment with fall-prevention intervention referral for at-risk groups to avoid falls could be cost-effective from a care-payer perspective. Aims to model the cost-effectiveness of a fall-risk assessment (QTUG compared to TUG) with referral to one of four fall-prevention interventions (Otago, FaME, Tai Chi, home safety assessment and modification) compared to no care pathway, when the decision to screen is based on older age in a primary care setting for community-dwelling people. Methods a cohort-based, decision analytic Markov model was stratified by five age groupings (65–70, 70–75, 65–89, 70–89 and 75–89) to estimate cost per quality-adjusted life years (QALYs). Costs included fall-risk assessment, fall-prevention intervention and downstream resource use (e.g. inpatient and care home admission). Uncertainty was explored using univariate, bivariate and probabilistic sensitivity analyses. Results screening with QTUG dominates (>QALYs; <costs) screening with TUG irrespective of subsequent fall-prevention intervention. The QTUG-based care pathways relative to no care pathway have a high probability of cost-effectiveness in those aged 75–89 (>85%), relative to those aged 70–74 (~10 < 30%) or 65–69 (<10%). In the older age group, only a 10% referral uptake is required for the QTUG with FaME or Otago modelled care pathways to remain cost-effective. Conclusion the highest probability of cost-effectiveness observed was a care pathway incorporating QTUG with FaME in those aged 75–89. Although the model does not fully represent current NICE Falls guidance, decision makers should still give careful consideration to implementing the aforementioned care pathway due to the modelled high probability of cost-effectiveness.

FALL PREVENTION PRIMER FOR THE PRIMARY CARE PRACTIONER:

2016 ◽  
Vol 2 (8) ◽  
Author(s):  
Mindy Oxman Renfro, PhD, DPT, CPH, PT ◽  
Joyce Maring, EdD, DPT, PT ◽  
Donna Bainbridge, EdD, PT, AT-Ret
Keyword(s):  
Primary Care ◽  
Fall Prevention ◽  
Fall Risk ◽  
Hospital Readmissions ◽  
Screening Tools ◽  
Evidence Based ◽  
Risk Screening ◽  
Quality Reporting ◽  
The Impact ◽  
Fall Risk Screening

<p><strong>ABSTRACT:</strong></p><p>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.</p><p>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.</p><p>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.</p>

Four-item fall risk screening tool for subacute and residential aged care: The first step in fall prevention

2009 ◽  
Vol 28 (3) ◽  
pp. 139-143 ◽  
Author(s):  
Caroline Stapleton ◽  
Peter Hough ◽  
Leonie Oldmeadow ◽  
Karen Bull ◽  
Keith Hill ◽  
...  
Keyword(s):  
Fall Prevention ◽  
Fall Risk ◽  
Screening Tool ◽  
Aged Care ◽  
Residential Aged Care ◽  
Risk Screening ◽  
Fall Risk Screening
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