Validating a multifactorial falls risk assessment.

Reducing risk of falls has been identified as a national safety goal by The Joint Commission (TJC). The purpose was to determine if the total score on the multifactorial Falls Risk Assessment accurately identifies the risk of falls in a homebound client. In addition, the study examined if any individual item had a higher predictive power with the incidence of falls. One hundred clients (> 65 years old) who sustained an avoidable fall during a home care episode of care, plus 25 home care clients in the same age range and time period, who did not fall. A retrospective chart review, including Falls Risk Assessment (FRA) performed at start of care, demographic information, specific physical therapy (PT) evaluation, and visit notes if necessary to determine if the fall met the inclusion criteria. Scores for each individual area of the assessment were collected for statistical analysis. Data were analyzed by a biostatistician using simple linear regression, t-tests, and regression of variable combinations. The total score on the multifactorial risk assessment tool was shown to have a strong relationship with incidence of falls. The average scores of individuals who fell after assessment were significantly higher than those of individuals who did not fall. No single factors were found to be highly predictive. A single approach to decreasing falls is likely to be less effective than a multipronged approach. Caregivers and providers are advised to consider the entirety of the falls risk and direct comprehensive interventions to address the multiple factors that lead to falls.

Consensus among experts in pediatric occupational and physical therapy on elements of individualized education programs.

PURPOSE: The aim of this study was to establish consensus among a sample of expert occupational therapy and physical therapy practitioners on characteristics necessary for individualized education program (IEP) objectives to be educationally relevant, measurable, and appropriate in content. METHODS: The Delphi technique was used to survey 38 board-certified clinical specialists from New Jersey, Pennsylvania, and New York. Nine physical therapists and 29 occupational therapists agreed to participate. RESULTS: The results of a three-round survey process revealed six characteristics of measurability, six characteristics of educational relevance, and seven characteristics related to content that were agreed on by 75% or more of the respondents. CONCLUSIONS: While IDEA is being readied for its next reauthorization, knowledge of these characteristics may be helpful to related service professionals in their participation for developing higher quality IEPs.