Accidental falls in hospital inpatients: evaluation of sensitivity and specificity of two risk assessment tools

Lovallo, Carmela; Rolandi, Stefano; Rossetti, Anna Maria; Lusignani, Maura

doi:10.1111/j.1365-2648.2009.05231.x

Cited by 52 publications

(63 citation statements)

References 8 publications

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“…Many tools have been developed based on identified risk factors, but perform very poorly when trying to identify patients who will fall with reasonable specificity and positive predictive value. 34,[39][40][41][42][43][44] In fact, it has been demonstrated that using a nurse's judgment, a physician's opinion based on a patient's likelihood to wander or a simple 2-question tool have all performed better than sophisticated risk calculators. 33,45,46 Therefore, it is possible that interventions could benefit from including all patients, with de-emphasis on unproven risk stratification tools.…”

Section: Dibardino Et Al |mentioning

confidence: 99%

Meta‐analysis: Multidisciplinary fall prevention strategies in the acute care inpatient population

DiBardino

Cohen

Didwania

2012

Journal of Hospital Medicine

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BACKGROUND:Inpatient falls are common adverse events that lead to inpatient injury, increased length of stay, healthcare costs, litigation, and are a focus of patient safety and healthcare quality. Fall prevention methods are currently evolving to address the problem.PURPOSE:To examine the available data evaluating multidisciplinary fall prevention strategies in the acute inpatient setting.DATA SOURCES:A complete literature search of MEDLINE, CINAHL, EMBASE and the Cochrane Library through December 2011 was used. The bibliographies of all systematic reviews and meta‐analyses were hand searched.STUDY SELECTION:Only primary research studies relating to acute care inpatient hospital multidisciplinary fall prevention were included. Selected papers were assessed for quality by 2 authors using a 20‐point scale previously used in the fall literature.DATA EXTRACTION:Each selected study was carefully hand searched by 2 authors for the purposes of data extraction. Study results, in fall rate per 1000‐patient days, and the characteristics of the interventions used were extracted for analysis.DATA SYNTHESIS:Effect sizes (odds ratios) and 95% confidence intervals were derived for individual studies and then combined across research reports using a random‐effects meta‐analysis.CONCLUSIONS:Fall prevention strategies have a significant but small effect on fall rates despite the use of complex, multidisciplinary interventions. Additional randomized trials are needed to examine the possible benefits of multidisciplinary fall prevention strategies in the acute inpatient setting. Journal of Hospital Medicine 2012; © 2012 Society of Hospital Medicine

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Section: Dibardino Et Al |mentioning

confidence: 99%

Meta‐analysis: Multidisciplinary fall prevention strategies in the acute care inpatient population

DiBardino

Cohen

Didwania

2012

Journal of Hospital Medicine

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“…Among them, the most frequent are illness/disease, use of devices, gait alteration, ocular, auditory and cognitive impairment, impaired mobility and previous history of falls. Extrinsic factors are commonly related to the hospital environment conditions and to situations involving health care by a caregiver and interdisciplinary team (9)(10) . Among the extrinsic risk factors are: light switches out of reach, stairs, slippery floor, mats/carpets, improper lighting and inadequate footwear (9) .…”

Section: Introductionmentioning

confidence: 99%

Factors associated with the risk of falls in hospitalized adult patients

Bittencourt

Graube

Stumm

et al. 2017

Rev. esc. enferm. USP

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OBJECTIVE Analyzing factors related to the risk of falls in hospitalized adult patients. METHOD A cross-sectional, analytical and quantitative study, developed in Clinical and Surgical Hospitalization Units from June to August 2015. Data collection instruments were sociodemographic and clinical forms, and the Morse Scale. Data were obtained with the patients and from medical records. Absolute and relative frequencies were used in the univariate statistical analysis, and chi-square test in the bivariate analysis. RESULTS 612 patients participated in the study. An association (p<0.001) was found between the high risk of falls and clinical neurological hospitalization, surgical trauma (hospitalization) and comorbidities such as diabetes mellitus, systemic arterial hypertension, visual impairment, vertigo and fear of falling. CONCLUSION An association between the risk of falls was found due to hospitalization, comorbidities and intrinsic factors. Regarding extrinsic factors, an association between mats/carpets and risk of falls was found. No association between the risk of falls with other extrinsic factors was found.

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“…Importantly, this score was developed and validated in a group of 1135 general patients in an acute-care hospital based on logistic regression analysis of more than 600 variables for each patient [10]. Sensitivity of 75% and specificity of 74% have been reported with the use of this score for predicting falls in hospitalized patients [10]; however, this has been challenged recently [14]. In our study, the Hendrich score was a poor predictor of falls; this finding may have been due to the high use of peripheral nerve blocks and the clustering of falls during the first 48 hours when the blocks may have produced motor block.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Patient Education Reduces In-hospital Falls After Total Knee Arthroplasty

Clarke

Timm

Goldberg

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Inpatient hospital falls after orthopaedic surgery represent a major problem, with rates of about one to three falls per 1000 patient days. These falls result in substantial morbidity for the patient and liability for the institution. Questions/purposes We determined whether preoperative patient education reduced the rate of in-hospital falls after primary TKA and documented the circumstances and the injuries resulting from the falls. Patients and MethodsWe reviewed data from all 244 patients who underwent primary TKA at a single institution between March and November 2009. Seventytwo patients of one surgeon were enrolled in a preoperative nurse-led education program. This group was compared with a control group of 172 patients who concurrently underwent TKA at the same institution but did not receive preoperative education. Results More control patients had in-hospital falls than those in the education group: seven (one of whom had two falls) of 172 (4%) versus none of 72 (0%), respectively.

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Accidental falls in hospital inpatients: evaluation of sensitivity and specificity of two risk assessment tools

Cited by 52 publications

References 8 publications

Meta‐analysis: Multidisciplinary fall prevention strategies in the acute care inpatient population

Meta‐analysis: Multidisciplinary fall prevention strategies in the acute care inpatient population

Factors associated with the risk of falls in hospitalized adult patients

Preoperative Patient Education Reduces In-hospital Falls After Total Knee Arthroplasty

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