257 Evaluation of Mobility and Fall Risk Among Seniors Presenting to the Emergency Department

Abstract

Increasing number of seniors 65 years of age and older are presenting to emergency departments (EDs) for care. This number is projected to double in the next 25 years. Mobility, ambulation, and fall risk are significant challenges for this population that may impact overall health and wellbeing, especially following an ED visit or hospitalization. The ED represents an opportunity to assess and screen for mobility and fall risks in this population. The objective of this study was to investigate the use of a mobility screening tool (Get-Up-and-Go or GUG) in the ED setting and determine what proportion may be at risk for injury. We conducted a prospective trial in a busy quaternary academic medical center ED (census 30,000 annually) with a high proportion of visits from for a five- month period from December 1, 2016 until April 30, 2017. Data was collected by nursing staff from patients age 65 or older who presented to the ED for care utilizing the GUG (Get-Up-and-Go) screening tool assessing mobility, balance, ambulation, and fall-risk. All ED nurses are required to be certified (by medical center policy) in performing the GUG screen. Descriptive statistics are presented. Data was collected electronically and statistical analysis was performed via SPSS ver 23. During the study period we saw 12280 patients in the ED, 3673 of which were seniors (age >65) representing 29.9% of all patients. During the study period, 2,777 seniors (75.6%) underwent GUG screening. Of these, nearly 40% (39.2%) had GUG values that demonstrated abnormal mobility testing. Furthermore, 339 patients (12.2%) demonstrated moderate or severely abnormal ambulation and mobility placing that high risk for fall and injuries either during the ED stay, hospitalization, or upon discharge from the ED. A patient with a score of 3 or higher on the GUG is considered at high risk for falls. The use of the GUG screening tool in our ED on all senior patients aged 65 and older, identified a significant portion of senior patients at risk for mobility and ambulation issues including but not limited to falls and the complications as a result. This data has helped start other initiatives in our geriatric ED including more resources and availability of physical and occupational therapists. Further study is needed to determine the impact of PT/OT assessments in the ED on length of stay, disposition, and patient/caregiver satisfaction.