OASIS Alert

Published on Mon Jun 08, 2009 PDF

Add these risk factors to your falls risk assessment.

If your patient uses a walker but has had no instruction in using it safely, don't be surprised to find her in the emergency room.

A new study published in the July issue of the Journal of the American Geriatric Society shows that injuries and hospital admissions for falls associated with walking aides are frequent in the over-65 population. The most common injuries are fractures, contusions, and abrasions.About one-third of the injured required hospitalization.

"An estimated 47,312 older adult falls injuries associated with walking aids were treated annually in U.S. emergency departments: 87.3 percent with walkers, 12.3 percent with canes, and 0.4 percent with both," the study reports. Seven times as many injuries occurred with walkers as with canes, and women were injured at a higher rate than men, the study says.

Heads up: Sixty percent of the falls injuries with walkers and canes occurred at home. Be sure your patients using walking aides are instructed in the safe use of these devices. And focus on safety issues when completing the OASIS assessment, experts advise. The study is available at www3.interscience.wiley.com/journal/119878233/issue.

Everyone talks about how pets can improve people's health but, until recently, very little was known about how they contributed to falls.

An estimated average of 86,629 fall injuries each year were associated with cats and dogs, according to data from the National Electronic Injury Surveillance System All Injury Program (NEISS-AIP) for the period 2001 to 2006. Substantially higher injury rates were associated with dogs compared with cats.

Nearly 88 percent of injuries were associated with dogs, and among persons injured, females were 2.1 times more likely to be injured than males, reports a Centers for Disease Control and Prevention's analysis of the NEISS-AIP data.

Twenty-six percent of the falls involving dogs occurred while persons were walking them,and the most frequent circumstances were falling or tripping over a dog (31.3 percent) and being pushed or pulled by a dog (21.2 percent). Falling over a pet item (e.g., a toy or food bowl) accounted for 8.8 percent of falls injuries.Approximately 38.7 percent involved other or unknown circumstances.

The most common injuries and the highest injury rates were for fractures and contusions/abrasions, and the highest fracture rates occurred among persons aged 75 to 84 years and those 85 years and over. Among hospitalized patients, 79.9 percent were admitted for fractures.The majority of falls injuries occurred inside or in the immediate environment outside the home.

Lesson learned: Prevention strategies should focus on increasing public awareness of pets and pet items as falls hazards and of situations that can lead to falls injuries, the CDC recommends. And it is also important to reinforce the American Veterinary Medicine Associa-tion's recommendations emphasizing obedience training, the report adds. When assessing a patient whose home environment includes cats or dogs, observe how the patient interacts with the pet and how the pet behaves. Address potential safety issues in your patient teaching. The study is at www.cdc.gov/mmwr/preview/mmwrhtml/mm5811a1.htm.