Adding value to the STRATIFY falls risk assessment in acute hospitals.

@article{Barker2011AddingVT,
  title={Adding value to the STRATIFY falls risk assessment in acute hospitals.},
  author={Anna Lucia Barker and Jeannette Kamar and Marnie Graco and Vicki Lawlor and Keith D. Hill},
  journal={Journal of advanced nursing},
  year={2011},
  volume={67 2},
  pages={
          450-7
        }
}
AIM This paper is a report of a study conducted to compare the predictive accuracy for fallers of The Northern Hospital Modified St Thomas's Risk Assessment Tool and St Thomas's Risk Assessment Tool, and to determine the inter-rater agreement of each tool. BACKGROUND Falls risk assessment is a key component of fall prevention. Investigation of clinimetric properties of a tool should be completed before it are used in clinical practice. METHODS Local falls data were used to inform… 

Comparison of the Reliability and Validity of Fall Risk Assessment Tools in Patients with Acute Neurological Disorders

The results suggest that the STRATIFY may be the best tool for predicting falls for acute neurological patients.

Validation and inter-rater reliability of a three item falls risk screening tool

There was an acceptable level of agreement between the 3 item AHFRST classification of falls risk and the longer, 9 item TNH-STRATIFY classification, however, both tools demonstrated limited predictive validity in the Austin Health population.

Diagnostic validity of the STRATIFY and Downton instruments for evaluating the risk of falls by hospitalised acute-care patients: a multicentre longitudinal study

The Downton and STRATIFY falls risk assessment instruments presented little utility as means of detecting the risk of falls among a sample of adult patients admitted to acute care hospitals.

Predictive Validity of the STRATIFY for Fall Screening Assessment in Acute Hospital Setting: A meta-analysis

The STRATIFY's predictive validity for fall risk is at a moderate level and is an appropriate tool to apply to hospitalized patients of the elderly at a potential risk of accidental fall in a hospital.

Development and Validation of the Fall Risk Perception Questionnaire for Patients in Acute Care Hospitals.

The fall risk perception questionnaire demonstrated satisfactory reliability and validity in an acute care hospital setting and showed statistically significant positive correlation with the Korean Falls Efficacy Scale-International and the Morse Fall Scale, thus establishing convergent validity.

Instruments for assessing the risk of falls in acute hospitalized patients: a systematic review and meta-analysis

The STRATIFY scale was found to be the best tool for assessing the risk of falls by hospitalized acutely-ill adults, however, the behaviour of these instruments varies considerably depending on the population and the environment, and so their operation should be tested prior to implementation.

Inpatient Falls

The goal is to present a stepwise approach to risk stratification which is broadly applicable to other areas requiring quality improvement, and a guide to implementing a quality improvement project around hospital falls.

VALIDITY OF TOOLS FOR ASSESSING THE RISK OF FALLS IN PATIENTS

Although one of the most frequently used tools for assessing the risk of falls in inpatients is the Morse Fall Scale, none of the tested tools is clearly recommended as the most suitable one for preventing falls in acute and long-term care settings explicitly showing high validity results.

Predicting geriatric falls following an episode of emergency department care: a systematic review.

The paucity of evidence in the literature regarding ED-based screening for risk of future falls among older adults is demonstrated, and screening tools and individual characteristics identified in this study provide an evidentiary basis on which to develop screening protocols for geriatrics adults in the ED to reduce fall risk.
...

References

SHOWING 1-10 OF 38 REFERENCES

Evaluation of three fall-risk assessment tools in an acute care setting.

The Heindrich II Fall Risk Model is potentially useful in identifying patients at high risk for falls in acute care facilities and has a more acceptable level of specificity than the Morse Fall Scale.

Prediction of falls using a risk assessment tool in the acute care setting

Good predictive validity for identifying fallers was achieved in a Canadian setting using a simple-to-obtain risk score that can easily be incorporated into practice.

Fall risk assessment: a prospective investigation of nurses' clinical judgement and risk assessment tools in predicting patient falls.

In this setting, the three methods of assessing fall risk showed good sensitivity but poor specificity, and all methods had limited accuracy, and overall, exhibited an inability to adequately discriminate between patient populations at risk of falling and those not atrisk of falling.

Using the Care Dependency Scale for fall risk screening.

Nursing assessment in hospitals could be simplified by using the Care Dependency Scale for fall risk screening, and high odds ratios and logistic regression analysis suggest that thecare dependency Scale item 'Avoidance of danger' indicated fall risk.

Fall risk factors assessment tool: enhancing effectiveness in falls screening.

The concept of continuous quality improvement in nursing care to implement a fall prevention program to reduce unnecessary injury was added to the effective tool to screen high-risk patients to assist nursing personnel in providing immediate and individualized care.

A simplified fall-risk assessment tool for patients hospitalized in medical wards.

It is suggested that a new simple and easy-to-use fall-risk assessment tool may enable us to prevent two-thirds of falls on the medical ward by providing effective fall-prevention facilities to only one-third of the patients.

Risk factors and risk assessment tools for falls in hospital in-patients: a systematic review.

A small number of significant falls risk factors emerged consistently, despite the heterogeneity of settings namely gait instability, agitated confusion, urinary incontinence/frequency, falls history and prescription of 'culprit' drugs.

Use of the 'STRATIFY' falls risk assessment in patients recovering from acute stroke.

STRATIFY performed poorly as a predictor of falls in a heterogeneous population of stroke patients and there is a need for a disease-specific rather than a generic falls risk assessment tool.

Screening the risk of falls: a general or a specific instrument?

The use of the CDS is preferred as it is more general and more reliable than the HFRM in predicting falls, and the workload for nursing staff can be decreased when only one instrument is used.

Design-related bias in hospital fall risk screening tool predictive accuracy evaluations: systematic review and meta-analysis.

Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular settings, but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment.