A Clinical Audit Of Current Assessment Of Falls In The Older Adult by the Pathfinder Service

Abstract Background Falls impact approximately 30% of older adults, negatively affecting quality of life (1). The 2022 World Guidelines for falls prevention and management for older adults (WFG) established evidenced-based international recommendations (2). The aim of this audit is to identify existing gaps in our assessment and interventions with patients who have fallen at home, and adopt key recommendations of the WFG into practice. Methods A retrospective analysis of Pathfinder documentation for (1) presentation of a fall (2) did not require hospital admission (3) timeframe August 2023 – January 2024. Sample size: 48. The audit tool was developed comprising of key domains from WFG 2022. Findings from the audit led to quality improvement process, introducing eight practice changes to align with the WFG 2022. The re-audit retrospectively analysed Pathfinder patient’s files who met the original inclusion criteria in the timeframe January- March 2025. Sample size: 15. Results Eight key practice changes aimed for 100% documentation of (1) delirium screen (2) lying/standing blood pressure (3) 12 lead ECG (4) standardised balance & gait screen (5) standardised activities of daily living assessment (6) standardised environmental assessment (7) falls risk stratification (8) 3 key questions. Implementation of these changes increased by 34% on re-audit, improving to 71% on average. The most significant included; 3 key questions increased by 72%, falls risk stratification from 12.5% to 79% and standardised mobility assessment compliance doubling. Conclusion The introduction of the WFG to our practice has enhanced assessment and interventions with patients who have fallen at home. Further quality improvements are now embed in team education and patient information. References (1) Ganz, D.A., Latham, N.K. Prevention of falls in community-dwelling older adults. N Engl J Med 2020;382:734–43. (2) Montero-Odasso, M. et al, World guidelines for falls prevention and management for older adults: a global initiative. Age and Ageing 2022; 51: 1–36, https://doi.org/10.1093/ageing/afac205.