CNE Article

Fall Risk Assessment in Geriatric-Psychiatric Inpatients to Lower Events (FRAGILE)

Sudip Nanda, MD, FACP; Tanujit Dey, PhD; Rudolph E. Gulstrand Jr., RPh, MBA; Daniel Cudnik, MD, FACS; Harold S. Haller, PhD

  • Journal of Gerontological Nursing
  • February 2011 - Volume 37 · Issue 2: 22-30
  • DOI: 10.3928/00989134-20100730-01
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Abstract

The objectives of this retrospective case-control study were to identify risk factors of falls in geriatric-psychiatric inpatients and develop a screening tool to accurately predict falls. The study sample consisted of 225 geriatric-psychiatric inpatients at a Midwestern referral facility. The sample included 136 inpatients who fell and a random stratified sample of 89 inpatients who did not fall. Data collected included age, gender, activities of daily living, and nursing parameters such as bathing assistance, bed height, use of bed rails, one-on-one observation, fall warning system, Conley Scale fall risk assessment, medical diagnosis, and medications. History of falls, impaired judgment, impaired gait, dizziness, delusions, delirium, chronic use of sedative or antipsychotic agents, and anticholinergic urinary bladder medications significantly increased fall risk. Alzheimer’s disease, acute use of sedative or anti-psychotic agents, and depression reduced fall risk. A falls risk tool, Fall Risk Assessment in Geriatric-psychiatric Inpatients to Lower Events (FRAGILE), was developed for assessment and risk stratification with new diagnoses or medications.

AUTHORS

Dr. Nanda is Attending Physician, Department of Internal Medicine, St. Luke’s Hospital, Bethlehem, Pennsylvania; Dr. Dey is Assistant Professor, Department of Mathematics, The College of William & Mary, Williamsburg, Virginia; Mr. Gulstrand is Board Member, Ohio Pharmacists Association, Columbus, Dr. Cudnik is Plastic Surgeon and Retired Chief of Staff, Lake Hospital System, Willoughby, and Dr. Haller is Director, Case Statistical Consulting Center, Department of Statistics, Case Western Reserve University, Cleveland, Ohio.

The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity, including research support.

Address correspondence to Sudip Nanda, MD, FACP, Attending Physician, Department of Internal Medicine, St. Luke’s Hospital, Bethlehem, PA 18015; e-mail: .sudipnanda2000@yahoo.com

doi: 10.3928/00989134-20100730-01

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