A prospective six-month study was conducted to determine a high-risk index for medical rehabilitation patients who fall. Variables studied for all patients included demographics, medical conditions, associated symptoms, orthostatic blood pressure measurements, physical function, posture control, proprioception, use of physical restraints, and medications, A detailed examination of the fall events was also conducted. Of the 143 patients studied, 46 (32%) fell at least once, making a total of 84 falls. Impaired ability to follow directions, impaired judgment, impaired proprioception, presence of physical restraints, use of major tranquilizers, use of sedatives, and presence of psychiatric diagnosis were all individually associated with patients who fell. Males fell more than females. Logistic regression identified altered proprioception as the only major predictor of falling. Of those who fell, only 26% called for assistance prior to the fall. Sixty-eight percent of the falls were from wheelchairs. Importantly, no patients had serious injury or morbidity from the falls.

From 2 million to 3 million people in the United States live with the aftereffects of stroke. Nursing diagnoses provide a taxonomy that enables nurses to identify similarities and differences for given groups of clients. The purposes of this study were to identify the most frequently chosen nursing diagnoses for rehabilitation stroke clients and to determine the corresponding objective clinical characteristics (related factors) of these diagnoses. A retrospective descriptive design was used to study charts from randomly selected stroke clients (N = 100) at a large rehabilitation center. At admission and at discharge, impaired physical mobility (99%) and self-care deficit (91%) were the most frequently occurring diagnoses. Impaired physical mobility was usually related to neuromuscular impairment, and self-care deficit was usually related to neuromuscular dysfunction. These objective clinical characteristics help to determine how diagnoses are unique to rehabilitation nursing practice.