What is the Briggs Fall Risk Assessment and Its Role in Senior Care?

Falls are a significant threat to the health and independence of older adults, with over a quarter falling each year. For healthcare providers, knowing what is the Briggs fall risk assessment is fundamental to creating effective prevention strategies and improving patient safety in senior care settings.

Quick Summary

The Briggs fall risk assessment is a standardized clinical tool used in senior care and residential facilities to systematically evaluate an individual’s risk of falling. It scores eight key parameters related to functional and clinical status to help clinicians determine a resident's risk level and develop a tailored fall prevention care plan.

Key Points

• Standardized Tool: The Briggs assessment is a structured tool for evaluating fall risk in senior care settings, especially residential facilities.

• Eight Core Parameters: It scores eight functional and clinical areas, including mental status, fall history, gait, and vision, to get a comprehensive risk profile.

• High-Risk Threshold: A total score often triggers immediate implementation of a personalized fall prevention protocol.

• Informs Care Plans: The assessment results guide the creation of targeted interventions like exercise, medication review, and environmental modifications.

• Part of a Larger Strategy: While a powerful tool, it's most effective when combined with other multifactorial prevention efforts and consistent monitoring.

• Not Just for Admission: The Briggs assessment is conducted upon admission, quarterly, and with any change in a resident's health or condition.

Understanding Fall Risk in Older Adults

Falls are a serious public health issue for older adults, often leading to fractures, head injuries, and other serious health complications. Beyond the physical harm, falls can also cause significant emotional distress, leading to a fear of falling that can restrict a senior's activities and independence. To combat this, healthcare facilities, especially those in long-term and residential care, utilize standardized tools to systematically evaluate and address fall risk. A prominent example is the Briggs fall risk assessment.

The Briggs Fall Risk Assessment Explained

The Briggs fall risk assessment is a paper-based or digital tool developed by Briggs Healthcare. It is designed to be used by clinicians, such as nurses and therapists, to screen residents for their likelihood of experiencing a fall. The assessment considers multiple factors known to contribute to falls in older adults, providing a structured and consistent method for evaluation. A key component of the Briggs tool is its scoring system, which assigns a numerical value to a resident's risk based on their status across eight key parameters.

The Eight Parameters of the Briggs Assessment

The Briggs assessment evaluates a resident's condition across eight key areas. The clinician assigns a score based on observational and historical data for each parameter. While the exact scoring can vary based on the specific version of the form, the core components generally include:

1. Mental Status: Assessing a resident's cognitive function, including alertness, memory, and orientation. Cognitive impairment can significantly increase fall risk due to poor judgment, confusion, and impulsive behavior.
2. History of Falls: Reviewing any falls that have occurred in the previous months. A history of previous falls is a strong predictor of future falls, and the Briggs tool weighs this history heavily.
3. Ambulation/Elimination Status: Evaluating a resident's mobility and continence. Issues such as urinary urgency or a need for frequent toileting can increase the rush to get to the bathroom, leading to falls. This section also considers the need for assistance with walking or transferring.
4. Vision Status: Assessing a resident's vision and its impact on their balance and perception of the environment. Poor eyesight can cause misjudgments of distance and depth, increasing the risk of trips and stumbles.
5. Gait/Balance/Ambulation: A direct evaluation of how the resident walks, their stability, and their ability to maintain balance. This is a critical component for identifying physical deficits that contribute to falls.
6. Medication Review: Evaluating the resident's current medication list. Certain drugs, especially sedatives, psychotropics, and polypharmacy (taking multiple medications), are known to increase dizziness, drowsiness, and unsteadiness.
7. Functional Behavior: This parameter considers behavioral aspects, including a resident’s willingness to cooperate with care and their adherence to safety instructions.
8. Environmental Awareness: While not a direct evaluation of the resident, this component prompts the clinician to consider how a resident interacts with their environment and any potential hazards. This can lead to adjustments in the care setting.

How the Briggs Score Guides Intervention

After assessing each of the eight parameters, the clinician totals the scores. For example, a score of 10 or greater typically signifies a high fall risk. This clear threshold triggers an immediate and documented fall prevention protocol. The Briggs assessment is not just a screening tool; it is a call to action. The results provide a baseline for the care plan and inform specific interventions tailored to the resident's identified risk factors. Follow-up assessments are conducted quarterly and whenever there is a significant change in the resident's condition, allowing staff to monitor progress and adjust the care plan as needed.

Comparing Briggs to Other Fall Risk Tools

While the Briggs assessment is widely used in residential care, other tools are common in different healthcare settings. Below is a comparison table outlining some key differences.

Assessment Tool	Common Setting	Primary Focus	Key Feature
Briggs Assessment	Residential/Long-Term Care	Multifactorial clinical and functional factors	Eight scored parameters for institutional use.
Morse Fall Scale	Acute Care Hospitals	Clinical factors (history, mobility, gait)	Fast, easy to use, and focused on in-hospital fall prevention.
Timed Up and Go (TUG)	Community/Outpatient	Functional mobility, balance, gait	Measures time to rise, walk a short distance, turn, and sit.
Berg Balance Scale	Community/Rehabilitation	Static and dynamic balance	Performance-based test using 14 tasks.

Each tool has its strengths and is best suited for different environments. The Briggs tool’s strength lies in its comprehensive, structured approach for long-term care settings, integrating clinical history with functional status.

Implementing Effective Fall Prevention Protocols

The most effective fall prevention is multifactorial, meaning it addresses several risk factors simultaneously. Based on a Briggs assessment, a care team can implement a variety of strategies:

1. Exercise and Physical Therapy

• Balance and strength training: Tai Chi, resistance bands, and targeted exercises improve stability and muscle strength, reducing the risk of falls.
• Gait training: Physical therapists can work with residents to improve their walking patterns and use assistive devices correctly.

2. Medication Management

• Review: Regularly review and, where possible, reduce high-risk medications such as sedatives or those that cause dizziness.
• Pharmacy Consultation: Collaborate with a pharmacist to identify medication side effects that contribute to fall risk.

3. Environmental Modifications

• Decluttering: Remove tripping hazards like throw rugs, excess furniture, and power cords.
• Lighting: Ensure adequate lighting, especially in hallways, stairwells, and bathrooms.
• Assistive Devices: Install grab bars in bathrooms and hallways, and ensure residents have properly fitted walkers or canes.

4. Other Interventions

• Vision Check: Ensure residents receive regular eye exams to keep vision correction up to date.
• Education: Inform residents and staff about fall risks and prevention strategies.

The Briggs assessment is a critical first step, but its real value is in translating the risk factors identified into a concrete, actionable care plan. For further reading on evidence-based fall prevention, the American Academy of Family Physicians offers valuable insights in its review titled "Preventing Falls in Older Persons."

Conclusion: A Proactive Stance on Fall Prevention

Understanding what is the Briggs fall risk assessment is key for any healthcare professional involved in senior care. This tool provides a systematic and comprehensive way to identify individuals at a heightened risk of falling, moving beyond simple observation to data-driven decision-making. By regularly employing the Briggs assessment, clinicians can implement targeted interventions and create a safer environment, ultimately preserving the health, dignity, and independence of older adults. It stands as a prime example of how proactive assessment can transform patient safety from a reactive measure into a preventative one.

Frequently Asked Questions

What is the primary purpose of the Briggs fall risk assessment?

The primary purpose is to systematically evaluate a resident's risk of falling by scoring eight parameters related to their health and functional status. This helps clinicians identify individuals at high risk and implement proactive prevention strategies.

Who typically uses the Briggs assessment tool?

The Briggs assessment is commonly used by healthcare professionals, such as registered nurses and certified nursing assistants, in residential and long-term care facilities to screen residents upon admission and on an ongoing basis.

What happens if a resident scores high on the Briggs assessment?

If a resident's score indicates a high risk (e.g., above 10), a fall prevention protocol is immediately initiated. This involves developing a tailored care plan with specific interventions, such as physical therapy, medication review, and environmental adjustments.

How often is the Briggs fall risk assessment performed?

The assessment is typically performed upon a resident's admission to a facility, at least quarterly, and whenever there is a significant change in the resident's physical or mental condition.

Are there other fall risk assessment tools besides Briggs?

Yes, other tools are used depending on the setting. Examples include the Morse Fall Scale, the Berg Balance Scale, and the Timed Up and Go (TUG) test. These tools focus on different aspects of fall risk.

Can the Briggs assessment be used for a senior living at home?

The Briggs assessment is specifically designed for use in residential care and clinical settings. For seniors living at home, simpler tools like the TUG test or a home safety checklist may be more appropriate for initial screening.

What factors are considered in the mental status parameter of the assessment?

The mental status parameter evaluates a resident's cognitive function, including their level of alertness, orientation to person, place, and time, and any memory impairments. Cognitive issues can affect judgment and impulse control, contributing to fall risk.