| name | langcare-fall-risk |
| description | Assesses fall risk using the Morse Fall Scale and medication-related fall risk factors from FHIR data. Identifies high-risk medications, environmental factors, and mobility impairments. Use when asked to assess fall risk, Morse fall scale, fall prevention, fall risk medications, or patient safety assessment for falls.
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Fall Risk Assessment
When to Use This Skill
Use when a clinician needs to evaluate fall risk for hospitalized or ambulatory patients using validated scoring tools and medication review.
Clinical Workflow
- Use
fhir_read to retrieve Patient demographics (age -- risk increases >65)
- Use
fhir_search to pull Condition resources: fall history, gait/mobility disorders, cognitive impairment, orthostatic hypotension, visual impairment, neuropathy
- Use
fhir_search to pull active MedicationRequest resources; flag fall-risk medications (see references/morse-fall-scale.md): benzodiazepines, opioids, antihypertensives, antipsychotics, antidepressants, sedative-hypnotics, anticonvulsants, anticholinergics
- Use
fhir_search to pull Observation resources: recent vital signs (orthostatic BP), mobility assessments, cognitive screening scores
- Apply Morse Fall Scale scoring from available data
- Present risk stratification with specific medication and non-pharmacologic intervention recommendations
FHIR Resources
- Patient -- Age
- Condition -- Fall history, gait disorders, cognitive impairment, visual impairment, neuropathy
- MedicationRequest -- Fall-risk medications
- Observation -- Orthostatic vitals, mobility assessments, cognitive scores, visual acuity
FHIR Query Examples
Pull Fall-Related Conditions
fhir_search(resourceType="Condition", queryParams="patient=[patient-id]&clinical-status=active")
Pull Active Medications
fhir_search(resourceType="MedicationRequest", queryParams="patient=[patient-id]&status=active&_count=100")
Clinical Guidelines
- CDC STEADI (Stopping Elderly Accidents, Deaths & Injuries) Initiative
- Morse Fall Scale for hospitalized patients
- AGS/BGS Clinical Practice Guideline for Fall Prevention (2010, updated)
- NICE CG161 Falls in Older People
Interpretation Guide
- Morse Fall Scale: 0-24 low risk (standard precautions), 25-50 moderate risk (implement fall prevention protocol), >50 high risk (high-risk interventions)
- Count fall-risk medications: >=4 fall-risk medications is an independent risk factor
- Orthostatic hypotension: SBP drop >=20 mmHg or DBP drop >=10 mmHg on standing; correlate with symptoms
- For each high-risk medication, recommend: taper if possible, reduce dose, schedule review, or provide specific rationale for continuing
Safety
- Never fabricate clinical data -- only report what FHIR returns
- Flag critical/abnormal values immediately
- Scope all FHIR queries to the authenticated patient
- Use standard terminology (LOINC, SNOMED CT, RxNorm, ICD-10)
- Present data in clinician-friendly format with reference ranges
