Each year there are thousands of older Americans (60 years or older) who fall and have severe accidents. This causes their medical expenses to rise exponentially higher due to an incident that may have been prevented. See just a few facts about falls from the Center for Disease Control and Prevention.
Statistics on Falling
- One out of five falls causes injury such as broken bones or head injury.
- Each year, 2.8 million older people are treated in emergency departments for fall injuries.
- Over 800,000 patients a year are hospitalized because of a fall injury, most often because of a head injury.
- Each year at least 300,000 older people are hospitalized for hip fractures.
- More than 95% of hip fractures are caused by falling, usually by falling sideways.
- Falls are the most common cause of traumatic brain injuries (TBI).
- Adjusted for inflation, the direct medical costs for fall injuries are $31 billion annually. Hospital costs account for two-thirds of the total.
Johns Hopkins provided a Fall Risk Assessment & Calculator which was created to assist nurses and caregivers in evaluating their patient’s chances of falling. Below is their checklist which helps determine a patient’s risks.
FALL RISK CALCULATION:
A. Age (single-select)
- 60 – 69 years (1 point)
- 70 – 79 years (2 points)
- greater than or equal to 80 years (3 points)
B. Fall History (single-select)
- One fall within 6 months before admission (5 points)
C. Elimination, Bowel and Urine (single-select)
- Incontinence (2 points)
- Urgency or frequency (2 points)
- Urgency/frequency and incontinence (4 points)
D. Medications: Includes PCA/opiates, anticonvulsants, anti-hypertensives, diuretics, hypnotics, laxatives, sedatives, and psychotropics (single-select)
- On 1 high fall risk drug (3 points)
- On 2 or more high fall risk drugs (5 points)
- Sedated procedure within past 24 hours (7 points)
E. Patient Care Equipment: Any equipment that tethers patient (e.g., IV infusion, chest tube, indwelling catheter, SCDs, etc.) (single-select)
- One present (1 point)
- Two present ( 2 points)
- 3 or more present (3 points)
F. Mobility (multi-select; choose all that apply and add points together)
- Requires assistance or supervision for mobility, transfer, or ambulation (2 points)
- Unsteady gait (2 points)
- Visual or auditory impairment affecting mobility (2 points)
G. Cognition (multi-select; choose all that apply and add points together)
- Altered awareness of immediate physical environment (1 point)
- Impulsive (2 points)
- Lack of understanding of one’s physical and cognitive limitations (4 points)
Total Fall Risk Score (Sum of all points per category)
Scoring: 6-13 Total Points = Moderate Fall Risk, >13 Total Points = High Fall Risk
The Johns Hopkins Hospital used the Johns Hopkins Falls Risk Assessment Tool (JHFRAT) and there was a 21% reduction in falling and fall injuries lessened by 51%. Learn how this point system can help you prevent falling incidents.
Centers for Disease Control and Prevention. (n.d.). Important Facts about Falls | Home and Recreational Safety | CDC Injury Center. Retrieved from http://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html
The Johns Hopkins Health System Corporation. (2007). Appendix A_JHFRAT. Retrieved from http://www.hopkinsmedicine.org/institute_nursing/models_tools/Appendix%20A_JHFRAT.pdf