The journal of nutrition, health & aging

, Volume 19, Issue 10, pp 1012–1018 | Cite as

Pro-active fall-risk management is mandatory to sustain in hospital-fall prevention in older patients - validation of the lucas fall-risk screening in 2,337 patients

  • V. S. Hoffmann
  • Lilli Neumann
  • S. Golgert
  • W. von Renteln-Kruse
Article

Abstract

Objectives

Prevention of in-hospital falls contributes to improvement of patient safety. However, the identification of high-risk patients remains a challenge despite knowledge of fall-risk factors. Hence, objective was to prospectively validate the performance of the LUCAS (Longitudinal Urban Cohort Ageing Study) fall-risk screening, based on routine data (fall history, mobility, mental status) and applied by nurses.

Design

Observational study comparing two groups of patients who underwent different fall-risk screenings; the LUCAS screening (2010 – 2011) and the STRATIFY (St Thomas’s Risk Assessment Tool In Falling Elderly Inpatients) (2004 – 2006).

Setting

Urban teaching hospital.

Participants

Consecutively hospitalized patients (≥ 65 years old) were screened on admission; LUCAS n = 2,337, STRATIFY n = 4,735.

Measurements

The proportions of fallers were compared between the STRATIFY and the LUCAS time periods. The number of fallers expected was compared to that observed in the LUCAS time period. Standardized fall-incidence recording included case-note checks for unreported falls. Plausibility checks of fall-risk factors and logistic regression analysis for variable fall-risk factors were performed.

Results

The proportions of fallers during the two time periods were LUCAS n = 291/2,337 (12.5 %) vs. STRATIFY n = 508/4,735 (10.7 %). After adjustment for risk-factor prevalence, the proportion of fallers expected was 14.5 % (334/2,337), the proportion observed was 12.5 % (291/2,337) (p = 0.038).

Conclusion

In-hospital fall prevention including systematic use of the LUCAS fallrisk screening reduced the proportion of fallers compared to that expected from the patients’ fall-risk profile. Raw proportions of fallers are not suitable to evaluate fall prevention in hospital because of variable prevalence of patients’ fall-risk factors over time. Continuous communication, education and training is needed to sustain in-hospital falls prevention.

Key words

Geriatric medicine risk management in-hospital falls fall-risk screening patient safety 

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Copyright information

© Serdi and Springer-Verlag France 2015

Authors and Affiliations

  • V. S. Hoffmann
    • 1
  • Lilli Neumann
    • 2
  • S. Golgert
    • 2
  • W. von Renteln-Kruse
    • 2
  1. 1.Institute of Medical Information Sciences, Biometry and Epidemiology (IBE)Ludwig-Maximilians-University MunichMunichGermany
  2. 2.Albertinen-Haus, Geriatrics CentreScientific Department at the University of HamburgHamburgGermany

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