Evaluation of the fall risk assessment tool in the institutionalized elderly

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<Purpose>We evaluated the fall risk assessment tool in the institutionalized elderly for two years. In the first year, we modified the fall risk assessment tool that we developed and tested it to 440 elderly patients who were newly admitted in two institutions. In the second year, we analyzed results and identified grounds of the nurses' intuition. In addition, we identified triggers could relate to fall occurrences on patients.<Methods>1)The number of subjects was 454 elderly patients in 2000 and was 1256 ones in 2001, staying in general hospitals, long-term-care facilities, geriatric health services facilities, and a rehabilitation unit during the research projects. 2)Subjects were assessed on the modified assessment tool within a few days from admission and moving and in the beginning of every month.<Results>1. The average score of the modified assessment tool, biside trigger, was 3.2±2.6. The sensitivity was 67.6 %, and the specificity was 75.0 % on the cutoff point of 4. The highest relative risk was nurses' intuition (RR :7.7), followed by wheel chair users on the transfer abilities (RR : 3.8), and history of falls (RR : 3.4). The grounds of nurse's intuition were mainly unstable body balance and transfer ability, totally 60-70 %. Adjusted odds ratios were obtained using multiple logistic regression. Only history of falls (OD :3.46) reached statistical significance.2. Fallers were 41 out of 730 elederly patients in two institutions during three-months period, and the highest relative risk was history of falls (RR :9.2). The relative risk of fallers without history of falls was more than 3 in nurses' intuition, transfer abilities, and trigger. In the same way, the highest relative risk in the rehabilitation unit was trigger (RR :3.6), indicating trigger could be fall risk factor. In short, the modified fall risk assessment tool can be divided by according to history of fals and can be distributed of scores by according to risk level, which can become effectie.