Peninsula Health Falls Risk Assessment Tool ‘poor’, says Macquarie University study

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The Peninsula Health Falls Risk Assessment Tool (PH-FRAT), used in residential aged care homes and a component of the National Aged Care Mandatory Quality Indicator Program, accurately predicted a fall within six months in just 33.6% of residents.

“It demonstrated poor predictive performance against the occurrence of actual falls. This raises concerns about its utility and value and may be preventing some residents from gaining access to necessary fall prevention interventions,” said lead researcher Dr Nasir Wabe, from the Australian Institute of Health Innovation at Macquarie University, 15km northwest of Sydney’s CBD.

“For residential aged care facilities already using the tool, lowering the cut-off score at which a person is deemed to be at higher risk, is a change that can be implemented easily and will immediately improve the safety of residents,” Dr Wabe said.

The study analysed electronic health records used to collect clinical and care management data, data from PH-FRAT assessments and fall incident data from 5,888 residents from 25 Anglicare residential aged care homes.

PH-FRAT was developed in 1999 by Peninsula Health, the public healthcare provider for Victoria’s Mornington Peninsula, and is used to identify whether major risk factors are present, being: recent falls, medications, psychological status and cognitive status. A value is then assigned to identify how at risk the person is of falling and this may guide care plans for fall prevention. A score above 14 indicates a fall scenario.

The tool is included in the Australian Commission on Safety and Quality in Health Care’s guidelines for fall prevention and is a key component of the recently expanded National Aged Care Mandatory Quality Indicator Program (QI Program).