La Porta, F., Valpiani, G., Lullini, G., Negro, A., Pellicciari, L., Bassi, E., Caselli, S., Pecoraro, V., & Govoni, E. (2024). A novel multistep approach to standardize the reported risk factors for in-hospital falls: A proof-of-concept study. Frontiers in Public Health, 12, 1390185. https://doi.org/10.3389/fpubh.2024.1390185
This article by La Porta et al. (2024) provides a systematic review and meta-analysis to standardize in-hospital fall risk factors, reducing 1,111 identified factors to 53 significant categories by linking them to international health classifications (ICF, ICD-10, ATC). By employing these standardized terms, it simplifies fall risk assessment and prediction. High‑impact risks include transfer difficulty (OR 8.63), bathing/washing (OR 6.16), gait disturbance, cognitive impairment, and exposure to psychotropics/antiepileptics (Tables 4–7; pp. 9–16). Nurses can utilize this standardized framework to guide admission/shift assessments, EMR flags, and pharmacist‑nurse medication reviews; prioritize assisted transfers, toileting, and dizziness/vision checks; and strengthen post-fall huddles and audit metrics, unit dashboards, and run charts for transparency. This tool can help nurses integrate high-risk categories into admission assessments, daily safety checks, and patient discharge planning. It is particularly useful in patient triage and post-fall evaluations, where risk factors are assessed in the context of the patient's medical and environmental conditions. By adopting this resource, nurses will gain clarity in fall risk documentation and improve patient safety outcomes through structured interventions.
Meekes, W. M., Korevaar, J. C., Leemrijse, C. J., & Van de Goor, I. A. (2021). Practical and validated tool to assess falls risk in the primary care setting: A systematic review. BMJ Open, 11(9), e045431. https://doi.org/10.1136/bmjopen-2020-045431
Meekes et al. (2021)'s article is a review of several assessment tools for fall risk that can be implemented in primary care settings, focusing on their practicality and effectiveness. The measures evaluated were the Timed Up and Go (TUG) test, Gait Speed test, Berg Balance Scale, and history of falls. Although none of these instruments showed enough predictive validity (AUC <0.7), a history of falls was identified to be the simplest measure for primary care settings because it doesn't need any training or equipment. Nurses can implement this instrument through consistent questioning about their history of falls during interviews, which would aid in identifying those who are prone to falling early. This approach is particularly useful for early identification of those who are likely to fall without necessitating intensive resources. The article also highlights that integrating clinical judgment with a history of falls would be useful for boosting methods of fall prevention. Nurses can incorporate this strategy through initial screenings and subsequent assessments, which would provide early interventions that would minimize falling incidents.
Strini, V., Schiavolin, R., & Prendin, A. (2021). Fall risk assessment scales: A systematic literature review. Nursing Reports, 11(2), 430-443. https://doi.org/10.3390/nursrep11020041
This systematic review, Strini et al. (2021), explores 38 fall risk assessment instruments utilized across healthcare practice, which it groups as commonly utilized and less frequently utilized instruments for particular settings, for example, psychiatric or pediatric environments. The article analyzes instruments, such as the Timed Up and Go (TUG) test, Morse Fall Scale (MFS), and the Berg Balance Scale (BBS), according to their predictive validity, user-friendliness, and versatility across different patient groups. Nurses may refer to this article to better understand the variety of different fall risk assessment instruments that exist and which are optimal for particular groups of patients or clinical environments. The article identifies that, because fall risk is multidimensional, no single instrument is solely ideal; however, an array of instruments frequently produces the most valid results. Nurses should refer to this knowledge when choosing an optimal fall risk assessment for their unit and account for patient condition, time allowance, and tool complexity.