197 IMPROVING THE ASSESSMENT OF VISION IN OLDER ADULTS AT RISKS OF FALLS AT A DAY REHABILITATION CLINIC

Abstract

Abstract Background Assessment of vision is a key component of multifactorial falls prevention programmes. However, the National Audit of Inpatient Falls (2015) found less than half of older adults had a vision assessment when admitted to hospital. We suspected vision assessment could also be improved for patients attending our outpatient Day Rehabilitation Unit who were falling or at risk of falls. Methods 21 outpatients were audited initially, with determination of baseline characteristics including age and Rockwood frailty score. We assessed whether past ophthalmological history was documented, whether the patient wore glasses and whether they had had a recent eye test in the community. Finally, documentation regarding visual examination was audited; this comprised range of eye movement, visual fields and visual acuity assessments. We adapted the clinic proforma to include a specific section on ophthalmology history and visual assessment; 14 patients were re-audited following intervention. Results Our two groups were relatively similar: mean age of 80 in the initial audit and 78 in the subsequent audit. Both groups had an average Rockwood score of 5. Improvements were noted in documentation regarding previous eye testing (33.3% - 86%), testing of eye movements (71.4% - 100%, and testing of visual fields (66.7% - 93%). There remained no testing of visual acuity following intervention. Conclusion A dedicated falls proforma targeting specific risk factors for falls improves identification and assessment of those risks. This enables targeted intervention and referral to be made to improve patient outcomes. For further improvement we would recommend educating the multidisciplinary team on how to test for visual acuity in the outpatient setting.