Developing a Clinical Decision Tree for Patients with High Risks of Falls

Monday, 30 July 2012

Pei-Ying Ho, BN, RN
Department of Nursing, National Cheng Kung University, Tainan, Taiwan
Miaofen Yen, PhD, RN
Department of Nursing & Institute of Allied Health Sciences, National Cheng Kung University, Tainan city, Taiwan
Chao-Hsing Huang, PhD
Department of Social Work, Chang Jung Christian University, Tainan, Taiwan

Learning Objective 1: The learner will be able to understand that nurses perspective of Fall Risk Assessment Tool.

Learning Objective 2: The learner will be able to assess patients with high-risk fall accurately and quickly.


 This purpose of this study was to develop a clinical decision tree for nurses to accurately assess high risk fall of patients.


 The study was conducted by semi-structured interviews of qualitative methodology, using qualitative data collected from 15 nurse of southern Taiwan who had at least one-year experience in medical or surgical area in hospital by purposive sampling to understand nurses’ perception of Fall Risk Assessment Tool. Transcripts and field notes were used during interview. A further systematic literature review of the Fall Risk Assessment Tool was carried out to gain a deeper understanding of the Fall Risk Assessment Tool in all aspects. The material of this study was obtained by searching the keywords fall risk and fall assessment within MEDLINE, Cumulative index to Nursing and Allied Health Literature (CINAHL), PubMed, The Cochrane Library, Chinese Electronic Periodical Services (CEPS), which restricted to English and Chinese language journals and reported from 2000 to 2011 year. The qualitative data was subsequently integrated with the systematic literature review for further analysis for constituting the clinical decision tree.


  It was found that Stratify and Morse Falls Scale were most commonly assessment tools. And three results of qualitative research were as follows: 1) The definitions of items were not standardized. 2) To use in Fall Risk Assessment Tool asked by oral frequently. 3) It was no time to assess the tool compelte. According to analyzed results, a clinical decision tree was developed using structure type by YES / NO pathway.


This clinical decision tree would be helpful for nurses to accurately and quickly screen patients with high risk fall. Howerev, it should be tested in clinical.