Paper
Friday, July 15, 2005
Testing of a Three-Step Fall Risk Assessment Tool
Kathy Lynn Rush, PhD, RN1, Cathy Robey-Williams, MS, MBA, RN2, Laura Michelle Patton, BSN2, Debra Chamberlain, MSN, RN3, Heather Bendyk, BS4, and Teresa Sparks, MSN, BN3. (1) Nursing, University of South Carolina Upstate, Spartanburg, SC, USA, (2) Spartanburg,Regional Healthcare System, Spartanburg, SC, USA, (3) Spartanburg, Regional Healthcare System, Spartanburg, SC, USA, (4) Spartanburg Regional Healthcare System, Spartanburg, SC, USA
| Learning Objective #1: Identify challenges associated with measuring fall risk assessment in the acute care setting |
| Learning Objective #2: Describe the process involved in developing an instrument for use in acute care practice |
Despite increased attention, falls continue to be a serious problem among hospitalized patients representing the largest category of reportable adverse events in acute care settings. Although extensive work has identified factors that put patients at high risk for falls, published fall risk assessment tools have been criticized for their low sensitivity and specificity. Such tools tend to measure intrinsic patient-related factors without direct assessment of the patients functional status. A risk assessment tool that combines both elements may be a more sensitive predictor of fall risk. Further, such an instrument must be user-friendly for nurses at the bedside, who are on the frontlines of fall risk assessment and management. The development of an instrument that eliminates complicated summative scoring and targets specific risk factors with immediate interventions appears warranted.
Objectives: The two-fold purpose is to: i) develop and test a user friendly falls risk assessment tool for use in predicting falls in the acute care population and ii) compare it to an established tool.
Design: Comparative, correlational design.
Population Sample, Setting: A convenience sample of approximately 127 in-hospital patients is being obtained from a Regional Medical Center in the Southeastern United States. Patients, 18 years and older, are being recruited from the hospitals seven adult medical-surgical units.
Method: Three admission nurses are collecting data on a minimum of two patients from their daily caseload using the newly developed tool and the well-known Morse Fall Scale. During the study period actual falls are being determined through monitoring of nurses self-reported computerized variance reporting of falls.
Findings and Conclusions: The new tool's reliability, validity, and sensitivity will be compared with the Morse Fall Scale.
Implications: Implications of the findings for tool refinement and hospital wide use will be discussed as well as plans for future research.