Can EMS providers and emergency department nurses work together to identify home risk factors for falls in older people?

Taiwan is an aging society and the ratio of falls among the older persons is high. Most falls occur at home, and multiple risk factors including home safety are involved. We propose a novel model of emergency medical technicians (EMTs) to assess home safety using scalable checklists. This study was conducted to evaluate its feasibility. This study was conducted between April 1, 2020 and March 31, 2021. The development of the risk factor assessment scale for falls in the home environment was divided into 2 stages. In stage 1, 2 researchers reviewed the extant literature. In stage 2, 6 experts judged the content validity index. According to EMT findings, emergency department (ED) nurses checked the items in the Checklist of Risk Factors for Falls in the Home Environment. The checklists were provided to the geriatric care manager (GCM) in the ED, who then discussed potential solutions with the patients or primary caregivers. A total of 235 participants were enrolled, and EMTs carried out environment assessment for 93.2% (219/235) of them. A total of 207 participants were at risk of falls at home and 79.7% (165/207) of them received intervention measures from the GCM according to the risk items. Education was the main intervention method, with 158 subjects. Moreover, seven subjects (4.2%, 7/165) were provided long-term care resources by the GCM with occupational therapists to help improve the environment at home. Our study provides an efficient method for EMTs to assess home fall hazards.