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Development of Anticipated Physiological Falls Prevention Ingenuities Bundles: A Preliminary Report
Published in Teuku Tahlil, Hajjul Kamil, Asniar, Marthoenis, Challenges in Nursing Education and Research, 2020
Goventhamah Subramaniam, Aini Ahmad, Zarin Ikmal Zan Mohd Zain
Anticipated physiological falls occur in patients whose scores on the MFS [Morse Fall Scale] indicate that they are at risk of falling yet the necessary preventions have not been practiced. Anticipated physiological patient fall is one of the classifications of falls which is on the rise despite all the fall preventive measures implemented. Many health institutions have developed fall initiatives to prevent falling events among patients in the hospital. Overall, as from a health care provider’s view, if anticipated fall can be prevented, how can the other types of falls be reduced or zeroed.
Falls
Published in Charles M Court-Brown, Margaret M McQueen, Marc F Swiontkowski, David Ring, Susan M Friedman, Andrew D Duckworth, Musculoskeletal Trauma in the Elderly, 2016
Oddom Demontiero, Derek Boersma, Gustavo Duque
Similar to the community population, a number of risk assessment tools have been studied in long-term care settings (Table 12.7). Of these the Morse Fall Scale (MFS) demonstrated high predictive values and can be completed in less than a minute making it probably the most useful nursing assessment tool for falls risk in long-term care facilities.
Long-Term Care Litigation
Published in Julie Dickinson, Anne Meyer, Karen J. Huff, Deborah A. Wipf, Elizabeth K. Zorn, Kathy G. Ferrell, Lisa Mancuso, Marjorie Berg Pugatch, Joanne Walker, Karen Wilkinson, Legal Nurse Consulting Principles and Practices, 2019
The interpretive guideline for accidents is called F-Tag F689 and encompasses accidents in LTC, including falls. A “fall” refers to unintentionally coming to rest on the ground, floor, or other lower level but not as a result of an overwhelming external force (such as a push). A fall without injury is still a fall, and the interpretive guidelines are clear that “unless there is evidence suggesting otherwise when a resident is found on the floor, a fall is considered to have occurred” (CMS, 2017b). However, for damages in a medical malpractice lawsuit, an injury must occur. For instance, an allegation may claim the resident fell 23 times, but if the defense can show there were no injuries, a tort may not have occurred. Long-term care facilities have great responsibility for the systematic assessment of risk and adequate supervision to prevent accidents, especially now that there is virtually no use of restraints in LTC (CMS, 2016a). In addition to the interpretive guidelines, an excellent resource for the standard of care in falls is the American Geriatric Society (AGS) Guideline for the Prevention of Falls in Older Persons. Contained in this reference are the most common risk factors for falls, which include (AGS Panel on Falls in Older Persons, 2001):Muscle weaknessHistory of fallsGait deficiencyBalance deficitUse of an assistive deviceVisual deficitArthritisImpaired ADLsDepressionCognition impairment andAge >80 years This clinical practice guideline is an evidenced-based document with risk factors, screening and assessment, and recommendations on interventions to prevent falls (AGS Panel on Falls in Older Persons, 2001). Formal fall risk assessment tools, such as the Morse Fall Scale and the Hendrich II Fall Risk Model, identify a resident’s fall risks such as history, diagnoses, ambulatory aids, gait, medications, and mental status, and use the total score to predict future falls. Most importantly, these risk assessments should be used to develop a comprehensive plan of care to prevent falls based on risk factors (Hendrich, 2007; Morse, 2008).
Does Age-Related Macular Degeneration (AMD) Treatment Influence Patient Falls and Mobility? A Systematic Review
Published in Ophthalmic Epidemiology, 2022
Hannah Garrigan, Jacquelyn Hamati, Parth Lalakia, Rosemary Frasso, Brooke Salzman, Leslie Hyman
Screening for risk factors or use of a validated instrument assessing fall risk is an alternative to performance-based assessments. Lee and Coleman advocated for the use of at least one instrument to define overall patient functioning when researching ocular treatments to demonstrate the impact on important health outcomes.17 The Best Practice Guidelines from ACS/NSQIP/American Geriatric Society also encourage postoperative assessment of fall risk factors through the use of a risk scale.47 The Morse Fall Scale mentioned in these guidelines is a validated six-question survey created to identify those with a high fall risk so preventive strategies can be employed. The Morse Fall Scale may be particularly useful in both ophthalmology research and clinical practice, due to its quick administration and negative predictive value of 99.3%.48 None of the studies included in this review used the Morse Fall Scale or other ways to score identifiable risk factors. Studies should include these important health outcomes to demonstrate their efficacy, but there is no consensus on an optimal tool at this time.
An analysis of fall incidence rate and risk factors in an inpatient rehabilitation unit: A retrospective study
Published in Topics in Stroke Rehabilitation, 2021
Kyu-Bum Lee, Jee-Sun Lee, In-Pyo Jeon, Do-Yeon Choo, Mi-Jung Baik, Eun-Hye Kim, Woo-Suck Kim, Chang-Sik Park, Jin-Young Kim, Young-Il Shin, Ji-Eun Bae, Jeong-Soo Kim
in the rehabilitation setting, a series of measurements were routinely administered at the time of admission and discharge. After the evaluation, most of the patients go through a 12-week rehabilitation intervention. The routine evaluation procedure included Tinetti Performance-Oriented Mobility Assessment-Ambulation (POMA-G), Timed Up and Go test (TUG), 10 m walk test and 2 min walk test, Korean version Mini-Mental State Examination (K-MMSE), FIM, Berg Balance Scale (BBS), and Global Deterioration Scale (GDS). in addition, data about the Morse Fall Scale (Morse FS) were collected for assessing fall risk.14–20 All assessments were administered by trained licensed clinicians.
A hospitalist’s role in preventing patient falls
Published in Hospital Practice, 2020
Screening tools are often implemented in hospital settings to alert staff to a patient’s increased fall risk. There are several validated, standardized, numeric tools that can be used to categorize patients into fall risk categories such as low, moderate, or high. Unfortunately, while validated to identify risk factors, few of these tools have demonstrated success in predicting actual patient falls in hospitals [2]. The Hendrich II Fall Risk Model and Morse Fall Scale have been recommended as standardized and validated tools by The Joint Commission [19]. There are numerous fall risk assessment tools, including the Hester Davis Scale, St. Thomas’s Risk Assessment Tool (STRATIFY), and Conley Scale [20–25]. These tools use different criteria to predict fall risk and can be integrated into the patient’s medical record. The Morse Fall scale calculates risk based on factors including history of falling, presence of a secondary diagnosis, ambulatory aid, IV access, gait impairment, and mental status to score patients at low, moderate, and high risk of falling [24]. The Hendrich II scale includes gender, mental/emotional status, dizziness, and medications [22]. The Hester Davis Scale is a newer tool, which includes nine factors including age, time from last fall, mobility limitations, high risk medications, mental status, toileting issues, hydration needs/volume status, sensory difficulties, and behavior characteristics [23]. A quick test that hospitalist clinicians can use at bedside is the ‘Timed Up and Go’ (TUG) test. The patient starts this examiniation from a seated position in a chair. The examinier instructs the patient to stand up, walk at a normal cadence to a marker of 10 feet (or 3 m), turn around, walk back to the chair, and sit down again. If the entire TUG test takes more than 12 s (a stop watch is helpful), the patient is identified as having a higher risk of falling, and further evaluation is necessary [26].