Redesigned Fall and Injury Management of Patients With Stroke.

Abstract

Falls and fall-related injuries remain a frequent complication of strokes.1 Fall and injury prevention based on fall risk scores and level of fall risk, such as low, moderate, or high, is insufficient, requiring that clinicians redesign fall prevention programs based on patients’ individualized fall and injury risk factors. The purpose of this article is to provide an overview of the selected evidence that supports redesign of fall prevention management of patients with stroke, thereby reducing their actual fall and fall-related injury risks. Clinical expertise is essential for safe fall prevention practices for these patients. Equipment use specifically designed to reduce trauma during a fall can be integrated into patient care. Although 1 in 20 deaths in the United States is attributed to strokes, ≈86% of people who experience a stroke live through the onset, care management, and rehabilitation.2 Each year, ≈23% of the strokes are new-onset ones, indicating that many individuals are living with the residual effects of a stroke and experience a repeat stroke.1 Strokes can occur across age groups with the risk of stroke increases with advanced age.2 The immediate and residual effects of stroke depend on the pathogenesis (anoxic, embolic, and thrombotic), location, and extent of cerebral involvement. Irrespective of the location of the stroke, stroke results in disability and reduces mobility in more than half of stroke survivors ≥65 years of age.3 Patient falls are a major health concern in the care of patients with stroke because falls are one of the most frequent complications among patients with stroke across settings of care, as these patients experience multiple falls. The evidence supports a multifactorial, interdisciplinary fall prevention program for reducing falls and injuries in acute care.4–6 Despite increased research on strategies to reduce both the rate of falls …