Meta-analysis of Fall-Risk Tools in Hospitalized Adults

Harrington, Linda; Luquire, Rosemary; Vish, Nancy; Winter, Melissa; Wilder, Claudia; Houser, Beth; Pitcher, Ellen; Qin, Haili

doi:10.1097/nna.0b013e3181f88fbd

Cited by 41 publications

(32 citation statements)

References 20 publications

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“…20 Since the initial evaluation of the STRATIFY risk tool (Figure 1) in 1997, multiple studies have examined the validity of the tool. 7,[22][23][24] A meta-analysis of 12 articles on STRA-TIFY completed by Harrington et al revealed that STRATIFY may be clinically useful in the specific settings where studied, but may not have accurate clinical use outside these areas. 22 When compared to other fall risk stratification tools, the STRATIFY had lower sensitivity and higher specificity.…”

Section: Risk Stratificationmentioning

confidence: 99%

“…The meta-analysis by Harrington et al stated that the MFS had significantly higher sensitivity, but lower specificity than that of STRATIFY. 22 The HFRM ( Figure 3) divides patients into normal/low risk (0-2), high risk (3-6), and extremely high risk (>6) for inpatient falls. 13 The original scale had a sensitivity of 77% and specificity of 72%.…”

Section: Risk Stratificationmentioning

confidence: 99%

See 1 more Smart Citation

Inpatient Falls

Cumbler

Simpson

Rosenthal

et al. 2013

The Neurohospitalist

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In this 2 part series, analysis of the risk stratification tools that are available, definition for the scope of the problem, and potential solutions through a review of the literature are presented. A systematic review was used to identify articles for risk stratification and interventions. Three risk stratification systems are discussed, St Thomas's Risk Assessment Tool in Falling Elderly Inpatients, Morse Fall Scale, and the Hendrich Fall Risk Model. Of these scoring systems, the Hendrich Fall Risk Model is the easiest to use and score. Predominantly, multifactorial interventions are used to prevent patient falls. Education and rehabilitation are common themes in studies with statistically significant results. The second article presents a guide to implementing a quality improvement project around hospital falls. A 10-step approach to Plan-Do-Study-Act (PDSA) cycles is described. Specific examples of problems and analysis are easily applicable to any institution. Furthermore, the sustainability of interventions and targeting new areas for improvement is discussed. Although specific to falls in the hospitalized patient, the goal is to present a stepwise approach which is broadly applicable to other areas requiring quality improvement.

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Section: Risk Stratificationmentioning

confidence: 99%

Section: Risk Stratificationmentioning

confidence: 99%

Inpatient Falls

Cumbler

Simpson

Rosenthal

et al. 2013

The Neurohospitalist

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show abstract

“…kao najpouzdanija i najpreciznija za upotrebu u akutno bolesnih hospitaliziranih odraslih pacijenata pokazuje se skala STRATIFY. Druga američ-ka studija 30 koja je uspoređivala Morseovu skalu i skalu STRATIFY osjetljivijom je procijenila Morseovu skalu, a slične rezultate dobili su i istraživači iz Južne Koreje, 28 koji su najveću prediktivnu vrijednost za identificiranje pacijenata u kojih postoji visoki rizik od pada dobili upotrebom Morseove ljestvice.…”

Section: Zaključakunclassified

Procjena rizika od pada: pregled skala za evaluaciju rizika

Licul¹,

Matteoni²,

Močenić³

2017

JAHS

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SažetakPad pacijenta u bolničkoj ustanovi spada u neželjene događaje u zdravstvenoj ustanovi te je jedan od pokazatelja sigurnosti pacijenta i indikator kvalitete u sustavu akreditacije. Otprilike trećina padova uzrokuje neki oblik ozljede pacijenta te direktno pridonosi smanjenju kvalitete zdravstvene skrbi uz različite psihofizičke poteškoće. Stoga je nužnost prevencije pada pacijenata važna dužnost svih zdravstvenih djelatnika, a posebno medicinskih sestara i tehničara. Jedan od alata za pomoć pri procjeni rizika od pada jesu standardizirane skale koje se primjenjuju u tu svrhu. U ovom radu prikazane su četiri različite ljestvice: Morseova skala, skala STRATIFY, skala Hendrich II. te skala koju je osmislilo osoblje baltimorske bolnice Johns Hopkins. Svaka od njih ima određene prednosti i nedostatke, a poželjno je da im je osjetljivost i specifičnost što veća. Idealna skala trebala bi biti jednostavna za upotrebu, precizna, ne iziskivati previše vremena za ispunjavanje te biti lako uklopiva u kliničku praksu bez dodatnog opterećivanja. Rezultat skale jest numerička vrijednost kojom se kod pacijenta procjenjuje rizik od pada (nizak, srednji, visok…) te se u skladu s time provode odgovarajuće preventivne mjere.Ključne riječi: sigurnost pacijenta, procjena rizika, pad u bolničkoj ustanovi, kvaliteta u zdravstvenoj njezi Datum primitka: 03.11.2016.

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“…The scales that were found to have good predictive validity for identifying potential falls are the Morse, Stratify and Schmid tools, and these are recommended for use by most health organizations. 21,23,24 All scales have one risk category in common: a history of falls. In addition, each scale includes other categories that are related to different risk factors contributing to falls.…”

Section: Factors Related To the Environmentmentioning

confidence: 99%

“…These factors include presence/absence of bed side rails, height and stability of any type of seats (including toilet seats) or obstacles such as furniture, power cables, slippery shoes, and an over-equipped patient's environment. 21,22 To assess the patient's fall risk in acute hospital settings, different fall risk assessment scales have been developed for prevention purposes. These scales are based on some of the factors related to the patient's medical condition.…”

Section: Factors Related To the Environmentmentioning

confidence: 99%

Falls Prevention in Hospitals-the Need for a New Approach an Integrative Article

Lipschuetz¹

2017

NCOAJ

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Among adults (65years and over), falls are the leading cause of injuries that cause pain, emotional distress and loss of independence, reduced quality of life, increased number of hospitalization days, morbidity and mortality.1 It is estimated that by 2025, this group of patients will constitute approximately 1.2billion of the world population, eighty percent of whom will live in developed countries. 2 The rate of falls among adult's increases with age, with the prospect of falls in people aged 65 and older at about 35%, increasing to about 42% for those over 75years of age. Fifteen percent (15%) of patients, who fall, have a history of falling twice or more a year. Falls are the second cause of death in the US (75% of them are elderly people) with the death rate in the United States reaching36.8 per 100,000 people.3 Fall rates in hospitals range from about 30% to 50% or a range of 3.3 to 11.5 falls per 1,000 hospitalization days, 4 and they are the most frequently reported adverse events. Fall-related morbidity and mortality rates in hospitals are significant. It is estimated that at least 3-20% of the falls have resulted in injury.5 About 30% of the hospitalized patients who fall suffer injuries due to the fall, of which 4-6% suffer from severe injuries, including fractures, brain hemorrhage, bleeding and mortality risks.6 Fall-related injury rate during hospitalization accounts for up to 533 per 1,000 person-years for all injuries, 20 per 1,000 person-years for hip fractures, 270 per 1,000 person-years for head injuries. 7A 'fall' is defined as "an unplanned descent to the floor with or without injury to the patient". 8 The National Database of Nursing Quality Indicators (NDNQI) is the largest national database of US data relating to quality of nursing care.9 Falls in hospitals is one of the quality indices measured by the NDNQI organization since 2003 as a proportion of all falls per 1,000 hospitalization days. The reported fall rates range from 1.3 to 8.9 falls/ 1,000 hospitalization days. 10,11The lowest rates of falls are reported in Intensive Care Units (1.3 per 1,000 hospitalization days), adult wards (3.92 per 1,000 hospitalization days), and the highest rates are reported in rehabilitation wards (7.3 per hospitalization 1,000 days).12 The main risk factors for falls in hospitalized patients are impaired gait, confusion, urinary incontinence, history of falls and psychotherapeutic medications. 13 Economical costsThe economic burden of falls in general hospitals is significant. Indeed, it was found that falls increased the cost of hospitalization per patients that have fallen to an average of $6,669, and if the injury was caused due to a fall, the extra cost is on average between $12,000 to $23,000.14 In 2013, the gross expenditure from falls in the U.S was AbstractCurrently, around the world, hospitals invest a considerable amount of effort into preventing patients' falls during hospitalization. Despite the intensive emphasis targeted in preventive intervention, reducing the prevalence of this phenome...

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Meta-analysis of Fall-Risk Tools in Hospitalized Adults

Abstract: Meta-analysis is a useful methodology for evaluating current evidence when variation exists in the literature.

Cited by 41 publications

References 20 publications

Inpatient Falls

Inpatient Falls

Procjena rizika od pada: pregled skala za evaluaciju rizika

Falls Prevention in Hospitals-the Need for a New Approach an Integrative Article

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