Physical Therapists and Physical Therapist Assistants' Knowledge and Use of the STEADI for Falls Risk Screening of Older Adults in Physical Therapy Practice in the United States.

Jennifer L. Vincenzo,Jennifer S. Brach,Tiffany E. Shubert,Colleen Hergott,Lori A. Schrodt,Subashan Perera,Jennifer Tripken

doi:10.3390/ijerph19031354

Abstract

Fall-risk screening and prevention is within the scope of physical-therapy practice. Prior research indicates United States-based physical therapists (PTs) and physical-therapist assistants (PTAs) use the Centers for Disease Control and Prevention’s STEADI (Stopping Elderly Accidents, Deaths, and Injuries) toolkit for community-based fall-risk screenings of older adults. However, clinically based fall-risk screenings and knowledge and use of the STEADI by PTs and PTAs is unknown. We conducted a cross-sectional survey distributed to a convenience sample of PTs and PTAs in the United States through email blasts and social media. PTs and PTAs (N = 425) who responded to the survey and worked in clinical settings with older adults were included. Eighty-nine percent of respondents reported conducting clinical fall-risk screening. Approximately 51% were ‘familiar’ to ‘very familiar’ with the STEADI, and 21.7% of the overall sample were not familiar at all. Only 26.1% utilize the STEADI for clinical fall-risk screening. Of the respondents who were ‘very familiar’ with the STEADI (n = 132, 31.1%), 84.1% (n = 111) reported using the STEADI in clinical practice. Seventy-six percent of respondents who use the STEADI implemented it by choice even though the majority (52.1%, n = 63) did not have it embedded in their documentation/workflow. Some PTs/PTAs can and do manage falls using the STEADI, but there is a gap in knowledge and use of the STEADI for falls management among PTs and PTAs in the United States. Further research is needed to identify the tools PTs use for multifactorial-fall screening and management and the impact of PTs’ use of the STEADI on patient outcomes.

Highlights

Physical therapists (PTs)/physical-therapist assistants (PTAs) who use the STEADI, the majority (52.1%, n = 63) do not have it embedded in their documentation/workflow
The results of our study are the first to identify a majority of PTs and PTAs in the United States (US) who responded to this survey reported conducting clinical fall-risk screening of older adults, and approximately half of those who are screening for falls have some knowledge of the STEADI
Three-fourths of respondents who use the STEADI implemented it by choice even though the majority did not have it embedded in their documentation/workflow

Summary

Introduction

Falls are the leading cause of fatal and nonfatal injuries among aging adults, costing upwards of USD 50 billion in yearly healthcare costs [1]. Many falls are preventable with screening to identify older adults at risk, followed by multifactorial assessments and interventions to ameliorate risks [1]. Physical therapists (PTs) and physical-therapist assistants (PTAs) are critical members of the healthcare team involved in fall prevention, most notably assessing balance and gait and providing exercise interventions for older adults at risk [2]. Gell and colleagues found that only 50% of older adults undergoing rehabilitation who were at risk of falls reportedly had falls addressed during

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