3.3 Propuesta técnica
3.3.2 Diseño del dispositivo de electroestimulación
Falls Risk for Hospitalised Older People (FRHOP) (To be completed on patient admission and after an acute episode)
Date of Assessment: / /
Place UR sticker here or add patient details:
Name: UR number:
General (do not score, but ensure appropriate actions) Nursing:
• Has the patient been oriented to the ward & routines, and a patient information brochure/booklet provided?
Yes
No • Patient’s environment assessed and safe? (seating type and height, bed height and assistive equipmenteg monkeybar/bedstick)
Yes
No• Is English the patient’s preferred language?
Yes
NoMedical staff
Recent falls (0-3) SCORE
• Has the patient fallen recently?
Nil in 12 months (0)
1 in the last 12 months (1)
2 or more in 12 months (2)
1 or more during their current hospitalisation (3)[ ]
• Did they sustain an injury?
No (0)
Minor injury, did not require medical attention (1)
Minor injury, did require medical attention (2)
Severe injury (fracture, etc) (3)[ ]
Medications (0-3)
• Is the patient on any medication?
No medication (0)
1–2 medications (1)
3 medications (2)
4 or more medications (3)[ ]
• Does the patient take any of the following type
of medication?
sedative
analgesic
psychotropic
antihypertensive
vasodilator/cardiac
diuretics
antiparkinsonian
antidepressants
vestibular supressant
anticonvulsants
None apply (0)
1–2 apply (1)
3 apply (2)
4 or more apply (3) [ ]Sub total for this page [ ]
Falls Risk Classification (please circle): Low / Medium / High
A pp en dic es Medical staff
Sub total from previous page [ ]
Medical conditions (0–3)
• Does the patient have a chronic medical
condition/s affecting their balance & mobility?
Arthritis
Respiratory condition
Parkinson’s Disease
Diabetes*
Dementia
Peripheral neuropathy
Cardiac condition
Stroke/TIA
Other neurological conditions
Lower limb amputation.
Vestibular disorder (dizziness, postural dizziness, Meniere’s disease…)
None apply (0)
1–2 apply (1)
3–4 apply (2)
5 or more apply (3)(* refer patients to Podiatry for a foot care review)
[ ]
Sensory loss & communications
• Does the patient have an uncorrected sensory
deficit/s that limits their functional ability?
Vision Hearing Somato sensory
No (0)
No (0)
No (0)
Yes (1)
Yes (1)
Yes (1)[ ]
Is there a problem with communication
(eg NESB or dysphasia)?
No (0)
Yes (1)[ ]
Cognitive status: (score 0–3 points)
• AMTS score
9–10 (0 point)
7–8 (1 point)
5–6 (2 points)
4 or less (3 points)[ ]
Nursing staff Continence
• Is the patient incontinent?
• Do they require frequent toileting or prompting
to toilet?
• Do they require nocturnal toileting?
No (0)
Yes (1)
No (0)
Yes (1)
No (0)
Yes (1) [ ] [ ] [ ]Nutritional conditions (score 0–3 points)
• Has the patient’s food intake declined in the past
three months due to a loss of appetite, digestive problems, chewing or swallowing difficulties?
No (0)
Small change, but intake remains good (1)
Moderate loss of appetite (2)
Severe loss of appetite / poor oral intake (3)[ ]
• Weight loss during the last 3–12 months.
Nil (0)
Minimal (<1 kg) (1)
Moderate (1–3 kg) (2)
Marked (>3 kg) (3)A pp en dic es Occupational Therapist
Patient Name: UR Number:
Sub total from previous page [ ]
Functional behaviour (score 0-3)
• Observed behaviours in activities of daily living
& mobility indicate:
Consistently aware of current abilities/ seeks appropriate assistance as required (0)
Generally aware of current abilities/occasional risk-taking behaviour (1)
Under-estimates abilities/inappropriately fearful of activity (2)
Over-estimates abilities/ frequent risk-taking behaviour (3)[ ]
Feet & footwear and clothing
• Does the patient have foot problems,
eg corns, bunions etc.
No (0)
Yes (1) (specify):[ ]
• The patient’s main footwear are/have:-
an inaccurate fit
poor grip on soles
in-flexible soles across the ball of foot
heels greater than 2 cm high/less than3 cm wide
flexible heel counter**
without fastening mechanism (ie lace,velcro or buckle.
slippers or other inappropriate footwear?
None apply (0)
One applies (1)
2 apply (2)
3 or more apply (3)(** half moon shape structure/stiffening at back of shoe)
[ ]
• Does the patient’s clothing fit well
(not too long or loose fitting)?
Yes (0)
No (1) [ ]Physiotherapist Balance (score 0–3 points)
• Were the patient’s scores on the Timed Up and
Go test and the Functional Reach test within normal limits?
Normal limits:—
Timed up and Go — less than 18 seconds
Functional Reach — 23 cm or more
Both within normal limits (0)
One within normal limits (1)
Both outside normal limits (2)
Requires assistance to perform (3)[ ]
Transfers & mobility (score 0–3 points)
• Is the patient independent in transferring and in
their gait? (Includes wheelchair mobility)
Independent, no gait aid needed (0)
Independent with a gait aid (1)
Supervision needed (2)
Physical assistance needed (3)[ ]
Total risk score [ ]
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Falls Risk for Older People in the Community (FROP-Com) Screen
Screen all people 65 years and older
(50 years and older Aboriginal & Torres Strait Islander people)
Date of screen: / /
(Affix Patient ID Label)
UR No Surname
Given Name
FALLS HISTORY SCORE
1. Number of falls in the past 12 months?
None (0)
1 fall (1)
2 falls (2)
3 or more (3)[ ]
FUNCTION: ADL status
2. Prior to this fall, how much assistance was the
individual requiring for instrumental activities of
daily living (eg cooking, housework, laundry)? • If no fall in last 12 months, rate current
function
None (completely independent) (0)
Supervision (1)
Some assistance required (2)
Completely dependent (3)[ ]
BALANCE
3. When walking and turning, does the person appear unsteady or at risk of losing their balance? • Observe the person standing, walking a few
metres, turning and sitting. If the person uses
an aid observe the person with the aid. Do not base on self-report.
• If level fluctuates, tick the most unsteady
rating. If the person is unable to walk due to
injury, score as 3.
No unsteadiness observed (0)
Yes, minimally unsteady (1)
Yes, moderately unsteady (needs supervision) (2)
Yes, consistently and severely unsteady(needs constant hands on assistance) (3)
[ ]
Total risk score [ ]
Total score 0 1 2 3 4 5 6 7 8 9
Risk of being a faller 0.25 0.7 1.4 4.0 7.7
Grading of falls risk 0–3 Low risk 4–9 High risk
Recommended actions Further assessment and management if
functional/balance problem identified
Perform the Full FROP-Com assessment
and / or