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by Rein Tideiksaar, PhD
Fall risk assessments can identify specific issues with each patient that hospitals and nursing homes can address to prevent falls.
Purpose of a fall risk assessment
- Identify patient/resident problems (rational basis for deciding whether risk exists)
- Identify those patients/residents most likely to fall
- Trigger further fall-related assessments (multidisciplinary)
- Identify interventions (guide patient/resident care planning)
- Raise staff awareness of fall/injury risk.
Fall Risk Components
| Components |
Fall Risk Factors |
| Diseases/Conditions |
- History of falls
- Impaired vision/hearing
- Urinary problems (toileting needs)
- Muscle weakness
- Gait/balance impairment
- Dizziness
- Orthostatic hypotension
- Mobility impairment (impaired bed, chair and/or toilet transfers)
- Uses cane/walker
|
| Medications |
- Polypharmacy(>5 medications)
- Psychotropics
- Diuretics
- Antihypertensives
- Antiseizure
- Benzodiazepines
- Hypoglycemics
- Sedative/hypnotics
|
| Mental Status |
- Dementia
- Depression
- Delirium
- Impaired 'safety' judgment
- Disruptive behaviors
- Non-English speaking
- Exhibits unsafe behavior
- Lacks understanding of mobility limitations
|
| Situational Conditions |
- New admission
- Floor-to-floor transfer
- Post fall
- Change of condition and/or starting fall risk medication
|
When to Conduct Fall Risk Assessments
A fall risk assessment should be obtained:
- Upon admission
- Post-fall
- Upon change of health condition (including medication changes)
- Daily/every shift (confused patients/residents; patients/residents taking
sedatives, recent fall, etc.)
Most Commonly Used Fall Risk Assessment Tools
- Morse Fall Scale
- Hendrich II Fall Risk Model
- St. Thomas Risk Assessment Tool (STRATIFY)
- John Hopkins Hospital Fall Assessment Tool
Posted May 2010
