Authors (including presenting author) :
Ng NCU (1), Tsui AYC(1)
Affiliation :
(1)Physiotherapy Department, Prince of Wales Hospital
Keyword 1: :
fall risk assessment
Keyword 2: :
fall prevention
Introduction :
Patients complained of gait instability or with fall history are often referred to Physiotherapy(PT) for fall risk assessment and treatment. This group of patients are known to have higher fall risk when receiving treatment in our Department. Polypharmacy or intake of medications associated with increased dizziness is known to increase fall risk of patients. However, medication screening is not being addressed in current PT fall risk assessment.
Objectives :
1) To integrate medications checking into PT fall risk assessment and management
2) To reduce fall incidents and enhance safety of patients with high fall risk in PT OPD
Methodology :
Clinical pathway for fall assessment & management was formulated after reviewing existing fall risk assessment. Apart from physical impairment, whether patients are taking any medication associated with increased dizziness which imposes fall risk was checked in the revised fall risk assessment. Causes of fall were identified in the assessment and corresponding advice and treatment were given to patients. If intake of medications associated with dizziness or polypharmacy was the cause of fall, liaison with Doctor to explore the possibility for medication titration was one of the means to reduce fall risk. Additional supervision would be arranged to these patients when they underwent training in our Department. They were also advised to perform home exercises under carer supervision. Audit was conducted to evaluate the fall risk assessment and management for patients who were referred for fall prevention. Items being audited included 1) whether medication taken associated with increased dizziness/ fall risk was checked. 2) whether appropriate advice/ treatment was provided after fall risk identified. 3) whether these patients experienced fall episode in our Department during treatment. The compliance of screening medication associated with increased dizziness/fall in fall risk assessment during January to March was reviewed.
Result & Outcome :
There were 19 patients referred for fall prevention education. The compliance of checking medication was 100%. Corresponding advice and management was delivered to all patients referred for fall prevention education in PT OPD. None of these patients reported fall in our Department during course of treatment. Medication screening in high fall risk patients helped reduce the fall incident and enhance patient safety in PT OPD.
