Visual Assessment in Elderly Inpatients Following a Fall.

Area of Science:

• Geriatric Medicine
• Ophthalmology
• Quality Improvement in Healthcare

Background:

• Falls are a significant cause of morbidity in older adults.
• Visual impairment is a key modifiable risk factor for falls.
• National guidelines recommend vision assessment post-fall, but adherence is suboptimal.

Purpose of the Study:

• To evaluate compliance with national vision assessment recommendations in elderly inpatients.
• To implement and assess the impact of interventions aimed at improving visual assessment rates post-fall.

Main Methods:

• A two-cycle retrospective cross-sectional review of electronic records of inpatients aged ≥65.
• Baseline assessment of vision assessment documentation (visual acuity or confrontational fields).
• Implementation of staff education, visual prompts, and improved access to tools, followed by a re-audit.

Main Results:

• Documented visual acuity assessment increased from 7.8% to 16.7% post-intervention (p=0.21).
• Confrontational visual field testing increased from 5.9% to 19% post-intervention (p=0.061).
• While not statistically significant, interventions demonstrated a positive trend in improving vision assessments.

Conclusions:

• Visual assessments are underperformed in elderly inpatients post-fall, despite existing guidance.
• Low-cost interventions, including education and improved tool access, can enhance compliance.
• Sustained multidisciplinary efforts and regular audits are crucial for integrating vision assessments into routine post-fall care.