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

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.

Download Full-text

Evaluating the Effectiveness of a Fall Risk Screening Tool Implemented in an Electronic Medical Record System

Journal of Nursing Care Quality ◽

10.1097/ncq.0000000000000315 ◽

2018 ◽

Vol 33 (4) ◽

pp. E1-E6 ◽

Cited By ~ 4

Author(s):

Shinichiroh Yokota ◽

Ai Tomotaki ◽

Ohmi Mohri ◽

Miyoko Endo ◽

Kazuhiko Ohe

Keyword(s):

Medical Record ◽

Electronic Medical Record ◽

Fall Risk ◽

Screening Tool ◽

Electronic Medical Record System ◽

Record System ◽

Risk Screening ◽

Medical Record System ◽

Fall Risk Screening

Download Full-text

Development of a Protocol for Improving the Clinical Utility of Posturography as a Fall-Risk Screening Tool

The Journals of Gerontology Series A ◽

10.1093/gerona/glq202 ◽

2010 ◽

Vol 66A (2) ◽

pp. 228-233 ◽

Cited By ~ 33

Author(s):

K. Edginton Bigelow ◽

N. Berme

Keyword(s):

Fall Risk ◽

Clinical Utility ◽

Screening Tool ◽

Risk Screening ◽

Fall Risk Screening

Download Full-text

P036: A comprehensive quality improvement initiative to prevent falls in the emergency department

CJEM ◽

10.1017/cem.2017.238 ◽

2017 ◽

Vol 19 (S1) ◽

pp. S90

Author(s):

P. Samuel ◽

J. Park ◽

F. Muckle ◽

J. Lexchin ◽

S. Mehta ◽

...

Keyword(s):

At Risk ◽

Emergency Department ◽

Quality Improvement ◽

Literature Review ◽

Fall Risk ◽

Screening Tool ◽

Risk Screening ◽

Constructive Feedback ◽

Patients At Risk ◽

Fall Risk Screening

Introduction: Patients from all population groups visit the emergency department (ED), with increasing visits by elderly patients. Patient falls in the ED are a significant safety concern, and they can lead to serious injuries and worse outcomes. Toronto Western Hospital’s ED Quality Improvement (QI) team identified as a problem our assessment and management of patients at risk for falls. The aim of this project was to develop a comprehensive and standardized approach to patients at risk of falls in the ED, including implementing timely interventions for fall prevention. Methods: A literature review of existing tools was completed to develop our own reliable and valid fall risk screening tool for ED patients. QI methods were used to devise a comprehensive strategy starting with detection at triage and implementation of action-driven steps at the bedside, through multiple PDSA cycles, randomized audits, surveys, and education. Repeated measurements were undergone throughout the project, as were staff satisfaction surveys. Results: The chart audits showed a five-fold increase in the completion rate of the fall risk screening tool in the ED by the end of the QI initiative (from 10% to 50%). Constructive feedback by an engaged team of nurses was used to iteratively improve the tool, and there was mostly positive feedback on it after various PDSA cycles were completed. The various component of this novel and useful ED-based falls screening tool and bundle will be presented in tables and figures for other leaders to replicate in their EDs. Conclusion: We developed a completely new ED-specific fall risk screening tool through literature review, front-line provider feedback, and iterative PDSA cycles. It was used for the identification, prevention, and management of ED patients with fall risk. We also contributed to a positive change in the culture of a busy ED environment towards the promotion of patient safety. Education and feedback continue to be provided to the ED nurses for reflective practice, and we hope to continue to improve our tool and to share it with other EDs.

Download Full-text

FALL PREVENTION PRIMER FOR THE PRIMARY CARE PRACTIONER:

Internal Medicine Review ◽

10.18103/imr.v2i8.165 ◽

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

ABSTRACT: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.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.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.

Download Full-text