Assessing Fall Risks Accurately

The last hospital I worked at had this huge emphasis on preventing falls, with a "NO Falls" tolerance. We had a safety officer walking up and down the hall at all times making sure call lights were within reach, bed wheels were locked, patients were toileted, etc. It still didn't prevent falls from happening. The tool we used to evaluate people didn't make sense. People that weren't fall risks could be a high fall risk according to the assessment. Now I'm at a hospital with a more exhaustive and accurate tool called the John Hopkin's Fall Risk Assessment. Here it is:

Complete the following and calculate fall risk score. If no box is checked, score for category is 0.

Points

Age (single-select)
o 60 – 69 years (1 point)
o 70 – 79 years (2 points)
o ³ 80 years (3 points)

Fall History (single-select)
o One fall within 6 months before admission (5 points)

Elimination, bowel and urine (single-select)
o Incontinence (2 points)
o Urgency or frequency (2 points)
o Urgency/frequency and incontinence (4 points)

Medications: includes pca/opiates, anti-convulsants, anti-hypertensives, diuretics, hypnotics, laxatives, sedatives, and psychotropics (single-select)
o On 1 high fall risk drug (3 point)
o On 2 or more high fall risk drugs (5 points)
o Sedated procedure within past 24 hours (7 points)

Patient care equipment: Any equipment that tethers patient, e.g., IV infusion, chest tube, indwelling catheters, SCDs, etc) (single-select)
o One present (1 point)
o Two present (2 points)
o 3 or more present (3 points)

Mobility (multi-select, choose all that apply and add points together)
o Requires assistance or supervision for mobility, transfer, or ambulation (2 points)
o Unsteady gait (2 points)
o Visual or auditory impairment affecting mobility (2 points)

Cognition (multi-select, choose all that apply and add points together)
o Altered awareness of immediate physical environment (1 point)
o Impulsive (2 points)
o Lack of understanding of one’s physical and cognitive limitations (4 points)



*Moderate risk = 6-13 Total Points, High risk > 13 Total Points Total Points