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Risk-factor assessment for falls: from a written checklist to the penless clinic
C A Dyer1, C L Watkins, C Gould
1Academic Department of Geriatric Medicine, University of Birmingham, The Hayward Building, Selly Oak Hospital, Raddlebarn Road, Selly Oak, Birmingham B29 6JD, UK. c.a.dyer@bham.ac.uk
Age and Ageing
|April 5, 2003
Summary
A checklist improved fall risk identification, but a dedicated falls clinic was most effective. This clinic identified numerous remediable risk factors in elderly fallers, highlighting the need for specialized care.
Area of Science:
- Gerontology
- Public Health
- Clinical Medicine
Background:
- Falls are a significant health concern for older adults.
- Effective identification of fall risk factors is crucial for prevention.
- Current methods for identifying fall risk factors in clinical settings have limitations.
Purpose of the Study:
- To audit the effectiveness of risk-factor identification for fallers before and after an educational program and checklist implementation.
- To evaluate risk-factor identification within a dedicated, computerized falls clinic.
Main Methods:
- Documentation of fall risk factors was reviewed on hospital wards.
- A self-auditing, computerized falls clinic was established.
- The clinic generated reports for medical notes and general practitioner letters.
Main Results:
- Checklist implementation improved, but overall ward-based risk factor identification remained poor.
- A dedicated falls clinic achieved near-complete identification of risk factors.
- In 112 patients (median age 82), common remediable factors included inappropriate medication (67%), footwear (59%), and postural hypotension (17%).
Conclusions:
- Ward-based interventions have limited success in identifying fall risk factors.
- Dedicated falls clinics are significantly more effective for comprehensive risk assessment.
- Portable computer programs for screening fallers warrant further consideration.
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