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Evaluation of an inpatient fall risk screening tool to identify the most critical fall risk factors in inpatients

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  • Wen‐Hsuan Hou
  • Chun‐Mei Kang
  • Mu‐Hsing Ho
  • Jessie Ming‐Chuan Kuo
  • Hsiao‐Lien Chen
  • Wen‐Yin Chang

Abstract

Aims and objectives To evaluate the accuracy of the inpatient fall risk screening tool and to identify the most critical fall risk factors in inpatients. Background Variations exist in several screening tools applied in acute care hospitals for examining risk factors for falls and identifying high‐risk inpatients. Design Secondary data analysis. Methods A subset of inpatient data for the period from June 2011–June 2014 was extracted from the nursing information system and adverse event reporting system of an 818‐bed teaching medical centre in Taipei. Data were analysed using descriptive statistics, receiver operating characteristic curve analysis and logistic regression analysis. Results During the study period, 205 fallers and 37,232 nonfallers were identified. The results revealed that the inpatient fall risk screening tool (cut‐off point of ≥3) had a low sensitivity level (60%), satisfactory specificity (87%), a positive predictive value of 2·0% and a negative predictive value of 99%. The receiver operating characteristic curve analysis revealed an area under the curve of 0·805 (sensitivity, 71·8%; specificity, 78%). To increase the sensitivity values, the Youden index suggests at least 1·5 points to be the most suitable cut‐off point for the inpatient fall risk screening tool. Multivariate logistic regression analysis revealed a considerably increased fall risk in patients with impaired balance and impaired elimination. The fall risk factor was also significantly associated with days of hospital stay and with admission to surgical wards. Conclusions The findings can raise awareness about the two most critical risk factors for falls among future clinical nurses and other healthcare professionals and thus facilitate the development of fall prevention interventions. Relevance to clinical practice This study highlights the needs for redefining the cut‐off points of the inpatient fall risk screening tool to effectively identify inpatients at a high risk of falls. Furthermore, inpatients with impaired balance and impaired elimination should be closely monitored by nurses to prevent falling during hospitalisations.

Suggested Citation

  • Wen‐Hsuan Hou & Chun‐Mei Kang & Mu‐Hsing Ho & Jessie Ming‐Chuan Kuo & Hsiao‐Lien Chen & Wen‐Yin Chang, 2017. "Evaluation of an inpatient fall risk screening tool to identify the most critical fall risk factors in inpatients," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(5-6), pages 698-706, March.
  • Handle: RePEc:wly:jocnur:v:26:y:2017:i:5-6:p:698-706
    DOI: 10.1111/jocn.13510
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    1. Seonhyeon Baek & Jinshi Piao & Yinji Jin & Sun‐Mi Lee, 2014. "Validity of the Morse Fall Scale implemented in an electronic medical record system," Journal of Clinical Nursing, John Wiley & Sons, vol. 23(17-18), pages 2434-2441, September.
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    1. Eun Hee Cho & Yun Jung Woo & Arum Han & Yoon Chung Chung & Yeon Hee Kim & Hyeoun‐Ae Park, 2020. "Comparison of the predictive validity of three fall risk assessment tools and analysis of fall‐risk factors at a tertiary teaching hospital," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(17-18), pages 3482-3493, September.

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    1. Eun Hee Cho & Yun Jung Woo & Arum Han & Yoon Chung Chung & Yeon Hee Kim & Hyeoun‐Ae Park, 2020. "Comparison of the predictive validity of three fall risk assessment tools and analysis of fall‐risk factors at a tertiary teaching hospital," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(17-18), pages 3482-3493, September.

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