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Falls risk assessment tools for use by health professionals
Title: Screening Assessment for Falls Evaluation (SAFE)
The SAFE assessment tool is a two-page screening tool intended to be used in addition to discipline specific assessments for seniors living in their own home or in independent living facilities who report a history of falls. It includes:
Note: The use of the scoring system is to provide a comparison between the initial and review assessment to reflect change in falls risk as a result of interventions put in place. It is not a predictive tool for future falls or an indicator of severity of risk.
Title: Falls Risk Screening and Action Plan Tool
A screening guide for health practitioners to identify falls risk in seniors living in their own home. It includes a one-page falls risk screen and overleaf a one-page action plan. The form is accompanied by guidelines outlining the objectives of the tool, the role of the health care provider and instructions for completing the form, including instructions for conducting the Timed Up and Go Test, an objective measure of mobility.
The original tool was based on the Screening Assessment for Falls Evaluation, Peninsula Health, Foothold on Safety Project, 1999, and the Queensland Health V3, Falls prevention best practice guidelines, 2003. In 2005 these resources were modified by the National Ageing Research Institute for greater consistency and ease of use.
Developed by: Darebin Community Health Service
In 2009 Darebin Community Health Service modified the screening guide for health practitioners developed by Banyule Community Health Service as part of their Make a Move project.
Title: The Falls and Injury Risk Profile for Unsteady Older Adults
This falls and falls injury risk assessment tool was developed by Michele Sutherland using a Delphi panel and other research validation as part of a Masters degree. The tool rates nine items on a 0-1, or 0-2 scale, and grades overall risk as low (0-3), medium (4-6) or high (7+).
An important difference of this tool relative to other falls risk assessment tools is that it includes a question about the presence of osteoporosis (for example risk of fracture). The tool includes a section with recommended interventions for each risk factor, and includes an action plan table to detail interventions to be implemented to address problems and risk factors identified.
The original tool was modified in 2009 by Bentleigh Bayside Community Health Service and later by the Department of Health Falls Prevention Resources Review Project, 2009.
Title: Falls prevention guidelines for general practitioners for assessing and managing older people
The guidelines were based in part (algorithm) on an article by the American Geriatric Society, British Geriatric Society, American Academy of Orthopaedic Surgeons, ‘Guideline for prevention of falls in older persons’. Journal of the American Geriatrics Society 49:664-672, 2001.
Title: QuickScreen©: Clinic falls risk assessment
(external link). For information contact Dr Anne Tiedemann (email@example.com)
This multifactorial tool was designed specifically for use in a clinical setting. It requires minimal equipment and is carried out in 5 to 10 minutes. It consists of measures for the following important falls risk factors: previous falls, medication usage, vision, peripheral sensation, lower-limb strength, balance and co-ordination. The package consists of:
The tool helps the user identify individual risk factors and calculate the combined increased risk that these factors present for future falls. It also helps in the development of an intervention plan to reduce risk and monitor progress over time.
A validity study was carried out involving 200 people (aged 75 years and over) and falls rates were monitored for one year. This study found the tool was able to accurately predict faller status. The tool also demonstrated good reliability, low measurement error and a high ability to detect change in physical status over time in a sub-group of 30 of these people. Also trialled in the clinical setting (40 clinicians - general practitioners, practise nurses and physiotherapists) it was found to be quick and easy to administer and useful in the management of older patients.
Note: Also available fromNeuroscience Research Australia (formerly Prince of Wales Medical Research Institute) are more detailed versions of this assessment. Contact the organisation for more information.
Title: Falls Risk for Older People – Community setting (FROP-Com)
This assessment tool was developed initially for use with hospitalised older people (the Falls Risk for Hospitalised Older People – the FRHOP). The FRHOP has been shown to have high retest and inter-rater reliability, and to have moderate ability to predict falls in older people in hospital (Australasian Journal of Podiatric Medicine, 2004: 99-108). The tool has been expanded and modified to become the FROP-Com for use in the community setting, and consists of 13 risk factors being rated, most on a graded 0-3 scale.