Article

PURPOSE: To evaluate effectiveness of fall-risk-assessment-based fall prevention
for stroke rehabilitation inpatients. METHOD:
A consecutive series of 232
patients admitted for the first time to a subacute stroke-rehabilitation ward
during 2010-2011 was studied in detail. The Assessment Sheet for Fall Prediction
in Stroke Inpatients (ASFPSI by Nakagawa et al.) was used to assess fall-risk
upon admission. Association of ASFPSI score and patient characteristics with
actual falls was statistically tested. Yearly incidence of falls per 1000
hospital days (HD) was retrospectively audited for the 2006-2014 period to
evaluate effectiveness of fall-risk reduction measures. RESULTS: The observed
incidence of falls over the detailed-study-period was 3.0/1000 HD; 39% of the
fallers fell during the first week after admission. ASFPSI score was not
significantly associated with falls. Longer hospital stay, left body-side
affected and non-extreme FIM score (55-101) were associated with higher odds of
fall. Introduction of fall-risk reduction measures followed by compulsory
fall-risk assessment lead to incidence of falls dropping from 7.1/1000 HD in 2006
to 2.8/1000 HD in 2011 and remaining at that level until 2014. CONCLUSIONS: The
fall-risk-assessment-based measures appear to have led to decreasing falls risk
among post-stroke rehabilitation inpatients classified as being at high risk of
falls. The fall prevention programme as a whole was successful. Patients with
non-extreme level of functional independence should receive enhanced fall
prevention. Implications for Rehabilitation Recognising the fall risk upon the
patient's admission is essential for preventing falls in rehabilitation wards.
Assessing the fall risk is a team tasks and combines information from various
sources. Assessing fall risk in stroke patients using the assessment sheet by
Nakagawa et al. immediately upon admission systematically draws attention to the
risk of falls in each individual patient.

Langue : ANGLAIS