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© 1998 Oxford University Press

other

Risk-factor assessment for falls: from a written checklist to the penless clinic

CHRISTOPHER A. E. DYER, CAROLINE L WATKINS1, CATHERINE GOULD2 and JED ROWE

Academic Department of Geriatric Medicine, University of Birmingham, The Hayward Building, Selly Oak Hospital Raddlebarn Road, Selly Oak, Birmingham B29 6JD, UK
1Aintree Stroke Unit, Fazakerley Hospital Liverpool, UK
2Assessment and Treatment Service, West Heath Hospital Birmingham, UK

C. A. E. Dyer. Fax (+44) 121 627 8304 e-mail c.adyer{at}bham.ac.uk

Objective: to audit risk-factor identification of fallers before and after an education programme and the insertion of a written checklist in medical notes. Risk-factor identification in a dedicated, computerized falls clinic was then examined.

Methods: documentation of risk factors for falls was studied on wards and a self-auditing ‘penless’ clinic for fallers subsequently set up to generate reports for medical notes and letters for general practitioners.

Results: risk-factor identification improved after the insertion of the checklist but remained relatively poor. A dedicated clinic allowed almost complete identification of risk factors. Of the first 112 patients (median age 82) seen in the clinic, 75 (67%) were housebound. Remediable risk factors—e.g. inappropriate medication (67%), unsatisfactory footwear (59%) and postural hypotension (17%)—were found in most. Thirty-three patients (29%) had difficulty with alarm raising.

Conclusion: ward-based intervention showed limited capacity to identify risk factors for falls: a dedicated clinic was more successful. The use of a portable computer with a programme to screen fallers for risk factors is worthy of consideration.

Keywords: audit, falls, nsk factors

Received June 19, 1997; accepted in revised form October 24, 1997.


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