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Current approaches to postfall assessment in nursing homes.
Deanna Gray Miceli1, Neville E Strumpf, Susan C Reinhard
1The John A. Hartford Foundation Post-Doctoral Fellow, University of Pennsylvania, Philadelphia 19104, USA. deannagm@nursing.upenn.edu
Journal of the American Medical Directors Association
|November 9, 2004
Summary
Nursing homes lack comprehensive postfall assessment (PFA) tools, leading to inconsistent evaluations of falls in older adults. Validated tools are needed to accurately determine fall causes and improve resident safety.
Area of Science:
- Geriatric Medicine
- Nursing Home Care
- Patient Safety
Background:
- Falls are a significant issue in nursing homes, affecting a large percentage of residents.
- Current postfall assessment (PFA) practices lack standardization due to the absence of validated tools.
Purpose of the Study:
- To examine the types of PFA tools used in nursing homes.
- To compare available PFA tools with national recommendations for geriatric fall assessment.
Main Methods:
- Surveyed 379 long-term care facilities in New Jersey for their PFA tools.
- Categorized tools and analyzed content against five recommended PFA domains (history, environment, physical exam, function, diagnostics).
Main Results:
- 149 facilities responded, revealing varied tools, with most using fall-risk assessment instead of PFA (63.7%).
- National PFA guidelines were largely missing, except for environmental factors (100%).
- Specific fall circumstances, medical history, and cognitive/ambulatory status were inconsistently assessed.
Conclusions:
- Comprehensive and validated PFA tools are not widely available in nursing homes.
- Inconsistent PFA practices hinder accurate etiology determination for falls.
- Development of improved PFA tools is crucial for clinical staff evaluating older adults who have fallen.