Falls Reported by Persons Seeking Outpatient Wound Care

Purpose: Falls are a concern in health care. The purpose of this project was to examine fall occurrence, fall injuries, balance confidence, and lower body strength in persons seeking outpatient wound care.

Design/Methodology: This was a quality improvement project; it used a cross-sectional, comparative design. Participants responded to demographic questions, the Activities-specific Balance Confidence Scale (ABC), fear of falling, fall numbers and injuries, and performed the 30-second chair rise test for lower body strength. Fall data were collected for each person for a mean of 4.09 months (SD = 1.61; range 1 to 7 months).

Results: Patients seeking wound care (N=106; Mean age=59.94 years) included men (n=70) and women (n=36); 101 were African American.  Sixty patients reported falling; 47 were recurrent fallers. Twenty patients stated they were injured, but did not seek emergency care. Higher number of total falls was significantly related to more comorbidities. Total falls were significantly related to fear of falling and ABC Scale scores. Of these patients, 97 were divided into those with injection related venous ulcers (IRVU=65) and those with venous ulcers from other causes (VUs-other=32). Those with IRVU and VUs-other did not differ significantly by age, sex, race, pain rating, number of falls, and fear of falling. Those with IRVUs (7.30) performed significantly more chair rises than those with VUs-other (4.72). Persons with IRVUs had significantly higher ABC Scale scores (63.24%) than those with VUs-other (49.38%). Persons with VUs-other were heavier and had more comorbidities, but these variables did not explain differences in chair rise or ABC scores.

Conclusions: Falls were a common occurrence. Thus, long term risk for fall injury would be high. Further research is needed to clarify the interactions between VU risk and patient factors such as strength, age, agility and impaired cognition.