Patient Fall Risk Assessment Record (PFRAR) in Outpatient Department

_{Shared by Singapore National Eye Centre (SNEC). GKPS Reference: Fall Risks Assessment Tools in Ophthalmic Ambulatory Setting. Global Knowledge Sharing Platform for Patient Safety (GKPS). 2023. A004.}

STRATIFY (The Modified St Thomas Risk Assessment Tool in Falling Elderly Patients)

Fall Risk Assessment Tools in Ophthalmic Ambulatory Setting

Falls is one of the most common risks for any health care organizations. Falls can result in serious complication for patients and hospitals.

There were limited studies done to test the validity and reliability of falls assessment tool in ambulatory settings. Majority were rigorously developed and evaluated suitable for hospital, acute or long-term facilities. In an Ophthalmic setting, the risk of fall is prominent with decrease visual ability due to multiple eye conditions and intervention for diagnosis & treatment, however, not sufficient to conclude or justify the similar level of risk for every patient. In fact, visual impairment had an overall poor predictive value in Morse’s study and was ranked fifth among other variables in the STRATIFY study (Papaionnou et. Al, 2004).

In a high turnover centre, we need a simple and relevant, yet reliable tool. A study was conducted in 2011 to evaluate the reliability of the “The Modified St Thomas Risk Assessment Tool in Falling Elderly Patients (STRATIFY)” versus existing Self developed tool in our settings.

A good reliability for STRATIFY (with a Kappa value of 0.6) as compared to than self-developed tool, p<0.01. STRATIFY showed a stronger inter-rater reliability than self-developed scale. This fall risk assessment tool was implemented since 2012 in Singapore National Ophthalmic Ambulatory setting.

References: Papaionnou A, Parkinson W., Cook R., Ferko N., Coker E., Adachi, J.D., 2004, Predicting of falls using risk assessment tool in the acute care settings, BMC Med, 2-1.