February 11, 2005

New screening looks for risk of falls, abuse, neglect

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Mark Wathen, M.D.

New screening looks for risk of falls, abuse, neglect

The nation's leading health care accreditation authority, the Joint Commission on Accreditation of Healthcare Organizations, is urging doctors and hospitals to undertake routine outpatient screening for abuse and neglect and for risk of falls.

A visit to a Vanderbilt Medical Group clinician already involves answering some basic written questions concerning current pain, nutrition, functional status (can you walk, bathe, speak, etc.), and education needs as they relate to self-care.

Any positive results are flagged in the electronic medical record and patients who screen positive get help.

Beginning Wednesday, Feb. 9, clinic staff at Vanderbilt University Medical Center will add two screenings for both new and returning patients who visit to see a doctor or nurse practitioner:

• Patients age 70 and above will receive a falls risk assessment.

• Adult patients will be screened for abuse and neglect.

Routine outpatient screening for child abuse will begin later this year.

The falls risk assessment uses a statistically validated questionnaire that asks about medications, past falls, vision, dizziness, etc. Patients found to be at risk for falls will be referred to their primary care providers for further assessment and prevention.

Adult patients will fill out a form asking if they are afraid of anyone at home, whether anyone threatens or hurts them, and whether the person responsible for helping them take care of themselves is failing. Patients who check yes to any of these questions will be offered a referral to a nurse for further assessment and help.

For cases in which patients appear to be hiding evidence of abuse or neglect, nurses will receive pointers to help them effectively broach the subject. Information on area referral resources for victims of abuse and neglect is distributed to all Vanderbilt Medical Group clinics.