Home-screen: a short scale to measure fall risk in the home.

Community nurses are often the health professionals with whom older Australians living at home have most contact. The home environment has been identified to have a number of hazards associated with falls in older people. The Home-screen scale was specifically designed as a nurse-administered instrument to identify environmental and behavioral risks that alert nurses to the need for action to reduce fall risks in the home. A 14-item scale was administered to 1,165 older people receiving community nursing services. Psychometric investigation confirmed a 10-item scale with construct validity and internal consistency (alpha = 0.86, n = 989), explaining 60% of the construct of home safety (safe home environment and safe home behaviors). In addition, differences in mean scores were found in clients able and unable to transfer independently (t = 4.5 [df = 323.1] p < 0.001 [Group 1: M = 82.14, SD = 15.56; Group 2: M = 75.54, SD = 20.83, n = 989]). Similarly, an association existed between clients with low scores on the Home-screen scale and the perceived need for home modification. A score of 74 on this scale has been identified as a critical point for potential client injury. The use of this scale, both as an initial screening instrument and as a monitoring tool for community nurses working with older people, is recommended.