Patient falls in hospitals

Patient falls in hospitals

Patient falls in hospitals account for a high proportion of adverse events. Assessing patient risk is a vital part of a fall prevention program. When a fall risk assessment tool is used, it is imperative to use one which is suitable for the hospital.Multiple falls risk screening tools have been proposed for use in the acute hospital setting including the Morse Fall Scale, Hendrich II Fall Risk Model, Schmid Fall Risk Assessment Tool, Johns Hopkins Hospital Fall Risk Assessment Tool, and St. Thomas’s Risk Assessment Tool (STRATIFY). We could utilize the Morse Fall Scale, one of the more commonly used scales, is comprised of six items: history of falling in past three months, presence of any secondary diagnosis, use of an ambulatory aid, receipt of intravenous therapy, abnormal gait, and impaired mental status, with composite scores ranging from 0 to 125. This tool can be used to identify risk factors for falls in hospitalized patients. The total score may be used to predict future falls, but it is more important to identify risk factors using the scale and then plan care to address those risk factors. A systematic review and meta-analysis of prospective studies suggests that falls screening tools are comparable with nursing clinical judgment when predicting falls in the acute hospital setting. Screening tools may be even less useful in the nursing home setting, where the majority of residents are likely to be at high fall risk. A prospective cohort study of 183 nursing home residents in Sweden found that both the staff’s judgment of fall risk and a prior history of falls were better predictors of future falls than commonly used screening tests for falls, such as the Get Up And Go test. Rather than implement falls screening, all nursing home residents who are able to transfer should be considered at high risk for falls.