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Table 3 Fall measures, data sources, calculation, and time points

From: CONNECT for quality: protocol of a cluster randomized controlled trial to improve fall prevention in nursing homes

Concept Measured; Source Calculation/Definition Includes six months prior to baseline Includes six months after FALLS ends
Demographics; Medical record Gender, Age, and Race. Nominal X X
Fall rate; medical record, MDS, incident reports, census Numerator: number of falls occurring in a 6-month period
Denominator: number of occupied facility bed days
Probability of recurrent falls; as above Proportion of residents with two or more falls occurring in a 6 month period X X
Fall risk reduction; medical record, MDS, incident reports Count of documented fall risk reduction indicators defined below X X
a) Orthostatic Blood Pressure Documentation of blood pressure in two positions, OR discontinuing medication, adding volume expanding medication, compression stockings X X
b) Sensory Impairment Documentation of presence or absence of visual impairment, OR Intervention to change corrective devices, add assistive technology to optimize sensory input X X
c) Footwear Documentation that footwear was evaluated, modified, or recommended to patient X X
d) Gait and Assistive Devices Physical therapy assessment or training, change in assistive device, or participation in restorative ambulation program X X
e) Toileting Documentation of scheduled toileting or a previous attempt in residents with at least intermittent urinary or bowel continence X X
f) Environment Documentation of a search for environmental factors contributing to fall risk (e.g., low toilet seat, room clutter, burned out light bulb) OR a change in environment likely to reduce falls or injury risk, including repairing grab bars, changing floor surfaces, changing lighting, re-arranging furniture, using a low bed or floor mat, and alarms X X
g) Psychotropic Medication Reduction [5362] Dose reduction or discontinuation of any of the following classes of psychoactive medications within 1 month of a fall; benzodiazepines, tricyclic antidepressants, antipsychotics, propoxyphene, and selected anticholinergic agents (diphenhydramine, sedating antihistamines, immediate-release oxybutynin, skeletal muscle relaxants) X X
h) Calcium and Vitamin D Prescription of at least 1,000 mg of calcium daily or 800 IU of vitamin D daily, OR equivalent dose regimens. Multivitamins containing vitamin D and combination calcium/vitamin D preparations will be added to the total daily dose calculation. X X