FESI-Analytic Summary

I. Introduction

The Falls Efficacy Scale-International (FESI-I) is a brief geriatric diagnostic tool that is designed to measure a patient’s fear of falling during physical or social activities, inside or outside of the home, regardless if the activity is actually carried out or not. The tool is a 16-question survey, presenting situations that the older adult may develop a fear of falling in attempting to complete. The patient responds on a Likert scale of 1-4 (1 being the least concerned about falling and 4 being the most concerned about falling.) The FES-I is self administered by the patient, after the Registered Nurse (RN) explains to answer each question with their concerns about falling whether or not they carry out the activity, and
In: Evidence-based geriatric nursing protocols for best practice, was updated by Boltz M, Capezuti E, Fulmer T, Zwicker D, after originally being published on July 30, 2003. This guideline reviewed published Meta-Analyses and systematic reviews to draw information from the most valid and highly evidenced information to develop quality standardized practices. This guideline focuses on assessing intrinsic and extrinsic factors that contribute to falls and how to recognize and improve conditions to decrease falls in hospitalized older adults. Intrinsic factors include the inherent properties that involves the older adult, that increase risk of falls such as increased age, deterioration of consciousness and mental status, comorbidities such as Parkinson’s, arthritis, or hip fractures, and gait, balance, or visual impairments. Extrinsic factors that are in the patient’s direct environment include slippery floors, proper lighting, inappropriate clothing or hospital gowns that may cause tripping, or IV poles that are not secure. This guideline also recommends implementing a Post Fall Assessment (PFA), which includes documentation of all aspects of the fall, as well as physical condition of the patient after the fall. In order to instill successful fall preventions, the guideline recommends that nursing care strategies implement standardized fall risk assessment tools that have been empirically tested for validity. The FES-I has been developed, validated, and is recommended for the older adult population, therefore incorporating this tool would be an appropriate resource to pinpoint who is at risk for falling and enable the multidisciplinary team to construct a plan of action to prevent falls in that particular patient. The FES-I would contribute to decreasing falls in the older adult populations by providing a feasible way to identify patient’s fear of falling by providing identification, and