Primary Care Nurses Systematically Assess Fall Risk, Provide Real-Time, Easy-to-Use Alerts to Physicians to Facilitate Appropriate Interventions for Those at Risk

Primary Care Nurses Systematically Assess Fall Risk, Provide Real-Time, Easy-to-Use Alerts to Physicians to Facilitate Appropriate Interventions for Those at Risk

Snapshot
Summary
Primary care clinic nurses and home-based primary care nurses at a Veterans Affairs medical center systematically assess the risk of falls in all patients. Using a modified version of an established test for fall risk (the 10 Foot Get Up and Go Test), nurses carefully observe patients as they walk into the clinic to identify any gait or balance issues; they also screen patients for risk of falling, inquiring primarily about any recent falls. Nurses record their observations through an electronic form (known as the Fall Risk Screen-Outpatient Reminder), including any comments they may have in an open text box. Physicians receive immediate alerts through the electronic medical record for those deemed to be at risk; the alert reminds them to assess certain risk factors (e.g., medication use, joint problems, vision changes, gait and balance problems) and to develop an action plan to reduce these risks (e.g., education, balance exercises, assistive devices, in-home review of environmental hazards). Although no formal program evaluation has been conducted, anecdotal feedback from physicians and nurses has been quite positive, and nearly all physicians and nurses routinely use the approach.

Evidence Rating
Suggestive: The evidence consists of anecdotal feedback and perceptions from doctors and nurses using the program; no formal evaluation has been conducted.

Developing Organizations
Jack C. Montgomery VA Medical Center
Muskogee, OK

Date First Implemented
2006
The program was pilot tested in the fall of 2006 and rolled out across the organization in January 2007.

Patient Population
Age > Senior adult (65-79 years); Aged adult (80+ years); Vulnerable Populations > Military/Dependents/Veterans

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AHRQ Innovations Exchange | Primary Care Nurses Systematically Assess Fall Risk, Provide Real-Time, Easy-to-Use Alerts to Physicians to Facilitate Appropriate Interventions for Those at Risk