Factors Associated with Falls in Psychogeriatric Inpatients and Comparison of Two Fall Risk Assessment Tools

Abstract

Development of a fall prevention programme for psychogeriatric inpatients is required. Therefore, the present study aimed to investigate factors associated with falls in psychogeriatric inpatients and compare two fall risk assessment tools. This study had two parts. First, all fall reports involving psychogeriatric inpatients in United Christian Hospital in 2016 were retrospectively reviewed. Factors associated with the falls were identified by comparing patients who had a fall incident and those who did not. Second, in a pilot study, 30 consecutive psychogeriatric inpatients were assessed for fall risk using the Morse Fall Scale (MFS) and the Wilson Sims Fall Risk Assessment Tool (WSFRAT), and outcomes were then compared with the modified Functional Ambulation Classification (MFAC). In 2016, 46 women and 47 men aged 65 to 94 years were admitted to the psychiatric wards (two women and two men were admitted twice). A total of 12 falls involving nine women and two men were reported. Over 66% of falls involved patients with dementia, 75% involved women, and over 50% occurred on the way to the bathroom, mostly during the night shift when the staffing level was low. In the pilot study, of 30 consecutive psychogeriatric inpatients, 20 were classified as high risk by the WSFRAT and 10 of them were also classified as high risk by the MFS. Those classified as high risk by WSFRAT matched perfectly with those classified as high risk by MFAC. However, 30% of those classified as high risk by MFAC were not classified as high risk by MFS. Patients with dementia and women had higher risk of fall. Extra proportion of at-risk patients are able to benefit from additional fall risk interventions when WSFRAT is used instead of MFS. Further studies are needed to calculate the psychometric properties of WSFRAT.