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Use of these tools helps identify elderly individuals at the highest risk for falls and aids in intervention planning.
ABSTRACT
Accidental patient falls are becoming a major cause of concern for hospitalized inpatients. It is well known that patients who fall once during their hospital stay are more likely to fall again and that fall rates tend to be higher in hospitalized elderly individuals. Concerned health care team personnel recognize that many accidental patient falls may be predicted and, thus, prevented. The best tool to predict falls has not been determined yet. The purpose of this study was to compare the abilities of the Morse Fall Scale (MFS), the Functional Reach (FR) test, and the nurses' clinical judgment in predicting those inpatients on a rehabilitation unit and a geriatric medical ward who were most likely to fall. A total of 98 patients were screened in a 3-month period, with each patient undergoing all three instruments the same day. The results showed that the two objective standardized tests (i.e., MFS, FR) were time consuming and often inconvenient and were no better at prediction than the clinical judgments made by the primary nurses.
Age generally has been accepted ' widely as a major risk factor in patient falls, and falls are among the leading causes of morbidity in this population. Approximately one third of individuals age 65 and older will fall each year, and the 1 -year mortality rate among individuals who suffer a fracture is more than 15% (Nickens, 1985).
Several studies have examined the variables that contribute to falls in elderly individuals. Higher risk of falling was identified in elderly patients who have impaired or decreased mobility of the lower extremities (Janken, Reynolds, & Sweich, 1986), who need assistive ambulatory devices because of impaired gait (Morse, Tylko, & Dixon, 1987), or who walk without the use of assistive aids (Uden, 1985). Several studies found confusion, bladder urgency, fecal incontinence, and diarrhea were significant variables (Hernández & Miller, 1986; Janken et al., 1986; Lund & Sheafor, 1985). Polypharmacy (especially diuretic, hypotensive, and anticonvulsant medications) also were found to be significant among those individuals who fell (Barbieri, 1983; Lund & Sheafor, 1985). Medical and neuropsychiatrie conditions and impaired vision and hearing also have been implicated...