The researchis to evaluate the Memorial Emergency Department Fall Risk Assessment Tool (MEDFRAT) for two emergency departments (EDs) at a hospital and determines whether it is as efficient as the Johns Hopkins Fall Risk Assessment Tool (JHFRAT) in predicting the fall risk of patients. It also evaluates the acceptance, by nurses, of MEDFRAT implementation in local EDs.
Background
Currently, EDs are using the JHFRAT, which is lengthy and does not meet patient needs. The hospital’s committee recommended the MEDFRAT; however, it needs evaluation before it is implemented.
Design
A two-stage, multi‐method design.
Methods
Data were collected from (a) patients over the past four years using a retrospective chart review, which included patients who fell (n= 56) and those who did not fall but were admitted to the same ED, at the same time, with the same conditions (n= 19); (b) patients (n= 435) who were newly admitted to the EDs; and (c) ED nurses (n= 18) who conducted the fall risk assessment for the newly admitted patients. We quantitatively analyzed the assessment scores, using the MEDFRAT and the JHFRAT, and qualitatively analyzed the opinions of nurses.
Results
For the patients assessed, MEDFRAT and JHFRAT ratings were associated.The nurses commented that the MEDFRAT optimized their workflow. One third had concerns about the accuracy of identifying at-risk patients using the MEDFRAT.
Conclusion
MEDFRAT is as efficient as the JHFRAT in predicting the ED patient fall risk; however, a score for “nurse judgment” was added to the MEDFRAT as an evaluation category for most nurses to accept the MEDFRAT.
Relevance to clinical practice
The MEDFRAT is more suitable for ED patients; however, including a nurse judgment score is recommended.
Impact Statement
What does this paper contribute to the wider global clinical community?
- The paper provides methods for EDs in the global clinical community to identify and evaluate the correct fall risk assessment tool for their patients.
- The paper provides strategies to revise a fall risk assessment tool for EDs.