Risk factors for and prediction of falls in an acute aged care psychiatry unit

Abstract

Objectives: To evaluate the predictive value of the Aged Care Psychiatry Unit (ACPU) Falls Screen and to describe the outcomes associated with falls in an acute aged care psychiatry unit. Methods: The development of the ACPU Falls Screen for use in an acute aged care psychiatry unit is described. Consecutive admissions to an acute aged care psychiatry unit were assessed prospectively with the ACPU Falls Screen, Health of the Nation Outcomes Scale for older persons (HoNOS 65+) and the Resource Utilisation Groups Activities of Daily Living (RUG ADL) Scale. Details of all falls and their consequences were documented on a falls incident form. Other information, extracted from medical records, included psychiatric and medical diagnoses, psychotropic medication prescription, electroconvulsive therapy (ECT), length of stay and demographic data. Multiple logistic regression was used to examine putative predictors of falls. Results: Ninety‐five admissions were included in the sample, of which 28 (29%) had falls. Multiple falls occurred in 16% of admissions. No serious injuries were recorded. Falls were associated with significantly higher scores on the ACPU Falls Screen, behavioural overactivity and recent receipt of ECT. However, falls were not associated with significant differences in psychiatric outcome, although multiple falls were associated with an increased length of stay. Receiver operating characteristic (ROC) curves for the ACPU Falls Screen indicated it had poor predictive value for falls. Conclusions: Falls are common in acute aged care psychiatry units. The ACPU Falls Screen was not a good predictor of falls. Universal precautions should be taken to prevent falls, particularly after ECT and in admissions with behavioural overactivity.