Predicting and assessing fall risk in an acute inpatient rehabilitation facility

Unintentional falls account for 70% of all hospital accidents. The objective of this study was to identify risk factors for falls and develop an assessment tool specific for an inpatient rehabilitation facility setting.

Diagnosis and Functional Independence Measure (FIM) scores were collected for 174 patients to assess predictors for fall risk. Independent t-tests, chi-square, and logistic regression analysis were conducted to examine differences between fallers and nonfallers.

We identified several risk factors for falls including 4 FIM items: toileting, bed transfer, tub/shower transfer, and stairs; and three diagnoses: right stroke, traumatic brain injury, and amputation. From these findings, we completed initial development of a risk assessment tool.

Evaluation of the tool suggests good specificity with 20%-30% of the patient population identified as high risk and good sensitivity by correctly predicting nearly 90% of patient falls.

Continued evaluation of this assessment tool is needed to identify effectiveness in predicting patients who are at high risk for falling.