Falls are a contributing factor to increased morbidity in the elderly and chronically ill populations and can affect overall quality of life. The literature indicates that oncology patients are a particularly vulnerable population who are further at risk for falls due to increased age, treatment related fatigue, side effects of medications, co-morbidities, decreased muscle tone, altered mental status, and anemia. Although patients with cancer are at a high risk for falls, this is not a well-documented patient problem in the nursing literature. This study examined the validity of the use of the Morse Fall Assessment Tool for use with Bone Marrow Transplant patients and explored other variables that might influence fall outcomes. This study was a retrospective chart review. The sample consisted of a total of 59 patients, which included 29 fallers and 30 non-fallers on a bone marrow transplant unit. There were 22 males and 37 females, ranging in age from 20 to 70 with a mean age of 53.9 (SD= 12.2).The results of this study indicate that there is a significant difference between fallers' (M= 43.8) and non-fallers' (M= 26.8) scores on the Morse Fall Scale (p= 0.000). Significant differences between groups were found with history of falls (p= 0.042), secondary diagnosis (p= 0.015), and muscle weakness (p= 0.025). Laboratory results from fallers and non-fallers revealed significant differences in platelet count (p= 0.003), BUN (p= 0.032), glucose (p= 0.009), and phosphorous (p= 0.001). This is the first study to document falls in the bone marrow transplant population. This study should be a stimulus for future studies conducted in the oncology and/or bone marrow transplant population. Studying falls in these patients is essential to understanding the physiological risk factors that may contribute to patient falls. Findings lay the foundation for studying falls in the bone marrow transplant population. It is crucial to study falls in this population in order to make appropriate assessments and interventions to keep this population free from injury.

Introdução: As quedas hospitalares interferem na funcionalidade do paciente durante e após a hospitalização. Nosso objetivo foi verificar se uma escala de identificação do risco de quedas (Morse Fall Scale) e um teste de avaliação de equilíbrio dinâmico (Mini-BESTest) identificam os idosos caidores durante e após hospitalização. Método: Trata-se de um estudo coorte prospectivo com análise retrospectiva. Participaram 154 idosos (>=65 anos) internados em duas enfermarias não cirúrgicas de Clínica Médica e Geriatria de um Hospital Universitário de porte extra. Foram realizadas avaliações do Mini-BESTest e da Morse Fall Scale (MFS) na admissão e na alta hospitalar. O acompanhamento das quedas foi feito por telefone em 1, 3 e 6 meses após alta hospitalar. Resultados: Os idosos foram divididos em: caidores (Grupo Q, n=5) e não caidores (Grupo NQ, n=149) na hospitalização. Na admissão não houve diferença significativa entre os Grupos Q e NQ nas ferramentas avaliadas (Mini-BESTest Q=23, NQ=20, p=0.85; MFS Q=25, NQ=15, p=0,87) e na alta hospitalar apenas na MFS (Mini-BESTest Q=20, NQ=22, p=0,22; MFS Q=50, NQ=25, p=0,01). Nos domínios \"Respostas Posturais\" do Mini- BESTest e nos domínios \"Histórico de Quedas\" e \"Tipo de Marcha\" da MFS houve diferença entre Q e NQ na alta (respectivamente, =0,02; p=0,01; p=0,02). Foi realizada uma subanálise com pareamento de dados por gênero, idade e comorbidades e também não foram encontradas diferenças clínicas, demográficas e nos escores das escalas entre os grupos Q (n=5) e NQp (n=10) (p > 0,05). Na predição de quedas pós-alta o Mini-BESTest apresentou AUC=0,53, p=0,50, sensibilidade 48,8% e especificidade 59,5%, já a MFS apresentou AUC=0,56, p=0,20, sensibilidade 44,2% e especificidade 72%. Houve um aumento de caidores nos 6 meses de Follow-up (11,2%, 15,6% e 17,1%;), e os pacientes com baixo risco de queda pela MFS tiveram mais quedas no Follow-up do que os pacientes de alto risco. Conclusão: Mini-BESTest e a Morse Fall Scale não identificaram os idosos caidores durante e após a hospitalização, apesar de alterações nos domínios na alta hospitalar e do aumento de quedas no Follow-up / Introduction: Hospital falls interfere with the patient\'s functionality during and after hospitalization. This study aimed to identify whether the Morse Fall Scale and Mini-BESTest can identify fall risk in elderly patients during and after hospitalization. Method: This is a prospective cohort study with retrospective analysis. A total of 154 consecutive elderly patients (>=65 years old) who were hospitalized at two clinical wards in a tertiary Hospital were included in the study. Mini-BESTest and Morse Fall Scale (MFS) assessments were carried out at hospital admission and discharge. The occurrence of falls was evaluated by phone calls 1, 3 and 6 months after hospital discharge. Results: Patients were divided in two groups, those who had falls (F group, n=5) and those who did not fall (NF group, n=149) during hospitalization. At hospital admission, no differences were observed between the F and NF groups in the Mini-BESTest (F=23 vs. NF=20; p=0.85) and MFS (F=25 vs. NF=15; p=0.87) scores. At hospital discharge, the F and NF groups had similar scores in the Mini-BESTest (F=20 vs. NF=22; p=0.22) but differences in the MFS (F=50 vs. NF=25; p=0.01). The domain assessments for \"postural responses\" of the Mini-BESTest and \"history of falls\" and \"type of gait\" of the MFS were different between the F and NF groups at hospital discharge (p=0.02, p=0.01 and p=0.02, respectively). A sub analysis was performed with data matching by gender, age and comorbidities and no clinical, demographic and scales differences were observed between the group F (n=5) and group NFm (n=10) (p > 0.05). In the prediction of post-discharge falls, the Mini-BESTest presented AUC = 0.53, p = 0.50, sensitivity 48.8% and specificity 59.5%, the MFS presented AUC=0.56, p=0. 20, sensitivity 44.2% and specificity 72%. There was an increase in the number of patients who fell from the 1st to the 6th month of follow-up (from 11.2% to 17.1%), and the patients with low and medium fall risk determined by the MFS had more falls in the follow-up period than those classified as high risk. Conclusion: Our results suggest that neither the Mini-BESTest nor the MFS identified elderly fall risk during and after hospitalization. In addition, we observed the need to supervise elderly patients after hospitalization

One and a half million people are currently living in residential care facilities; as the baby boomer generation ages, this number will increase to 3 million. Approximately 3 out of 4 residents of these facilities fall each year, and 10% to 20% of those falls result in serious injuries such as fractures, disability, and a decreased quality of living. The BOUNCE Back fall initiative is a multifactorial program that uses a systematic approach starting on admission and to re-evaluate a resident following a fall. Nursing and therapy uses the Morse Fall Scale and the Elderly Mobility Scale to assess and categorize the resident's risk for falls. Guided by Lewin's theory of change, this project was designed to assess the effectiveness of the fall initiative as a quality improvement 60-day (August 2016- September 2016) pilot study in a skilled nursing and rehabilitation facility as a potential means to reduce the number of resident falls. Sixty residents (aged 64 to 98, mean age 81) were assessed at a minimum 2 time points to determine their level of fall risk and needed intervention, within 60 minutes of admission to the facility and 7 days postadmission. De-identified pre- and post-implementation data were provided from the corporate quality measure database, entered into a spreadsheet, and numbers were compared. As a result of the fall prevention pilot, for August 2016, 5 falls occurred with no repeat fallers; September 2016, 3 falls with 1 repeat faller which is a significant decrease from 14-22 falls occurring per month for 2 consecutive years. Following implementation, the facility scored 3%-5% for the number of falls, which is below the 7% threshold set forth by the pilot facility's corporate office. Prior to the implementation of the initiative, the facility had not met the 7% fall threshold in 2 years