Improving visual assessment of older people attending a falls assessment clinic, Whiteabbey Hospital

Introduction

Falls are common in older adults, resulting in hospitalisation, and significant morbidity and mortality. NICE guidelines recommend that vision should be assessed in adults who fall. However, in a national survey of falls services, 54% of professionals checked vision. The falls assessment clinic allows adults to be assessed by a multiprofessional team including doctors, nurses, physiotherapists and occupational therapists. The aim of this quality improvement project was to improve documentation of visual assessment within the medical notes to >90%.

 

Method and Results

Baseline data showed that 79% of clinic attendees had documentation of date of last eye check and 64% had documentation regarding whether they used glasses. None had visual acuity assessed, 68% had eye movements assessed and 54% had visual fields tested.

A PowerPoint presentation was created to educate staff on common ophthalmology conditions and introduced staff to the RCP bedside vision check for falls prevention assessment tool. A laminated bedside visual acuity sheet was placed in each clinic room. Data was recollected, which showed improvement in the documentation of visual acuity to 60%, eye movements to 80% and visual fields to 100%.

PDSA cycle 2 involved creating a poster reminding doctors of the 5 steps needed as part of a vision assessment as well as recommendation of steps to take if an issue was identified. Following this, 100% of clinic attendees had documentation regarding date of last eye check and whether they wore glasses. All had eye movements, visual fields and basic bedside visual acuity documented for near and far vision.

 

Conclusion

Key success of the project included education of the multiprofessional team to highlight importance as well as provision of resources to be used. In the future, this project could be expanded to ensure a standardised approach to visual assessment of older adults across the Trust.