Royal College of Physicians, UK has collaborated with National Audit of inpatient Falls (NAIF) to produce a quick eyesight assessment tool for patients who are at risk of falling and injuring themselves during their stay at the hospital.
The team behind the formation of this tool also included members from Royal College of Physicians and the British and Irish Orthoptic Society, NHS, Royal College of Nursing, the College of Optometrists and the Royal College of Ophthalmologists.
This assessment tool can be conveniently used by doctors, therapists and nurses to assess visual impairments in patients at their hospitals.
Over years, evidence has shown that visual impairment in patients, particularly in older patients, has caused tripping and falling during their stay in a healthcare facility which results in injuries that can turn severe and increase healthcare costs.
Although this problem is prevalent across a large number of healthcare units globally, it can be resolved effectively if timely visual assessment of the patient is carried out by the doctor.
It is not possible for caregivers to assess visual impairments in patients who come in large numbers for a variety of other ailments. However, their diseases can be connected to or affected by their visual performance and stimuli which mostly go unexamined by the clinicians.
The risk of increased rate of falling in patients remain multifactorial and the most common causes include reduced muscle strength, decreased eye movement reflexes, body balance issues (increased postural sway), behavioral and cognitive changes, eye sight impairment leading to navigation problems and the presence of associated pre-existing medical conditions.
Statistics recorded by NAIF suggest that more than half of the older patients do not get assessed for visual impairment in a hospital setting.
NIAF goes out to add that inpatient falls are common with an average 600 falls per day which cumulatively account for over 240,000 annual cases in a hospital setting. With numbers being sky high in both acute hospital and mental healthcare facilities in Wales and England, the resulting injuries pose a serious challenge to the National Healthcare Service (NHS).
According to the NIAF recommendations, the local health boards and trusts in the UK should take some measures to reduce the tripping incident rates in hospital settings. The guidance include formation of falls steering groups that record the incidents and report them to the board of organization so that timely interventions can be formulated.
Similarly, it is advised that multidisciplinary working groups be formed, audit of bed rail use should be adopted and review of multifactorial falls risk assessments be carried out.
It is also advised by the NIAF that every patient who is over 65 years of age should be provided with a medication review by the doctor to check for side effects that increase the risk of falling.
Patients of this age should also be checked for visual impairment and a smooth functioning of a workable policy should be used to assure that all the patients are provided with walking aids and call bells at the time of hospital admission and during the stay.
Similarly, older patients who have self-control (continence) issues should be giving special care to reduce their changes of falling.
With the introduction of this novel assessment tool, it is anticipated that the visual impairment assessment would be readily available for every patient seeking medical help.
This assessment tool makes use of a combination of visual aids and questions that helps the doctor in assessing integral visual functions in a patient and includes visual tests for near and distance vision assessment. In addition to this, the tool also carries information about vision problems and eye-related conditions commonly found in older people to help the clinicians assess the patient accuracy even if they do not have a specialization in ophthalmology.
Although it is a good addition to the currently practiced clinical practices, by no means this tool is a substitute to the expert opinion on eye problems.