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APHA Scientific Session and Event Listing

Richard Fortinsky, PhD¹, Dorothy Baker, PhD, RNCS², Margaret Gottschalk, PTMS³, Mary King, MD⁴, Patricia Trella, MA¹, and Mary Tinetti, MD⁵. (1) Center on Aging, University of Connecticut Health Center, 263 Farmington Ave., Farmington, CT 06030-5215, 860-679-8069, fortinsky@uchc.edu, (2) Department of Internal Medicine, Yale University School of Medicine, One Church Street 7th Floor, New Haven, CT 06520, (3) Department of Rehabilitation Services, Yale-New Haven Hospital, PO Box 208025, New Haven, CT 06520, (4) Division of Geriatric Medicine, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102, (5) Department of Medicine, Yale University School of Medicine, PO Box 208025, New Haven, CT 06520

Background: Falling remains a leading cause of preventable injury and mortality in the older population; older patients receiving homecare are at increased risk. Objectives: (1) To describe Fall Risk Assessment and Management (FRAM) strategies used by homecare nurses and rehabilitation therapists participating in the Connecticut Collaboration for Fall Prevention (CCFP). This initiative provides training and materials to move evidence-based multifactorial FRAM strategies into practice. (2) To contrast use of FRAM strategies according to whether or not homecare clinicians attended specific FRAM training. Design: Cross-sectional study using self-administered questionnaires. Participants: 124 nurses and 60 rehabilitation therapists from in 18 homecare agencies participating in CCFP. Results: Among all respondents, fall risk factors most commonly assessed were postural hypotension (83%), mobility (79%), and balance (71%). As expected, therapists were more likely to assess mobility and balance, with nurses more likely to assess medications. Respondents who attended FRAM in-service training (82% of total) were statistically significantly (p<0.05) more likely than non-attendees to assess mobility (83% vs 59%) and balance (75% vs 50%) during home visits, review and discuss FRAM information with patients at homecare discharge (85% vs 63%), and address medication issues and postural hypotension by referring to the physician at discharge (56% vs 31%). Conclusions: Homecare clinicians who participated in specific FRAM training, including use of readily available patient handouts, were significantly more likely to implement FRAM strategies during visits and at discharge. These findings suggest that, given training and support, homecare clinicians can collaborate to provide a multifactorial approach to fall prevention.

Learning Objectives:

• Describe the prevalence and consequences of falls in the older population.
• Explain how homecare nurses and rehabilitation therapists address risk factors for falls during visits and at homecare discharge.
• Articulate how homecare clinicians can implement fall prevention strategies using evidence-based strategies.

Keywords: Home Care, Aging

Related Web page: www.fallprevention.org

Presenting author's disclosure statement:

Any relevant financial relationships? No