The STRATIFY tool and clinical judgment were poor predictors of falling in an acute hospital setting


Autoria(s): Webster, Joan; Courtney, Mary D.; Marsh, Nicole; Gale, Catherine; Abbott, Belynda; Mackenzie-Ross, Anita; McRae, Prue
Data(s)

2009

Resumo

Objective: To compare the effectiveness of the STRATIFY falls tool with nurses’ clinical judgments in predicting patient falls. Study Design and Setting: A prospective cohort study was conducted among the inpatients of an acute tertiary hospital. Participants were patients over 65 years of age admitted to any hospital unit. Sensitivity, specificity, and positive predictive value (PPV) and negative predictive values (NPV) of the instrument and nurses’ clinical judgments in predicting falls were calculated. Results: Seven hundred and eighty-eight patients were screened and followed up during the study period. The fall prevalence was 9.2%. Of the 335 patients classified as being ‘‘at risk’’ for falling using the STRATIFY tool, 59 (17.6%) did sustain a fall (sensitivity50.82, specificity50.61, PPV50.18, NPV50.97). Nurses judged that 501 patients were at risk of falling and, of these, 60 (12.0%) fell (sensitivity50.84, specificity50.38, PPV50.12, NPV50.96). The STRATIFY tool correctly identified significantly more patients as either fallers or nonfallers than the nurses (P50.027). Conclusion: Considering the poor specificity and high rates of false-positive results for both the STRATIFY tool and nurses’ clinical judgments, we conclude that neither of these approaches are useful for screening of falls in acute hospital settings.

Formato

application/pdf

Identificador

http://eprints.qut.edu.au/26112/

Publicador

Elsevier

Relação

http://eprints.qut.edu.au/26112/1/26112.pdf

DOI:10.1016/j.jclinepi.2009.02.003

Webster, Joan, Courtney, Mary D., Marsh, Nicole, Gale, Catherine, Abbott, Belynda, Mackenzie-Ross, Anita, & McRae, Prue (2009) The STRATIFY tool and clinical judgment were poor predictors of falling in an acute hospital setting. Journal of Clinical Epidemiology, 63(1), pp. 109-113.

Direitos

Elsevier Inc. All rights reserved.

Fonte

Centre for Health Research; Faculty of Health; Institute of Health and Biomedical Innovation; School of Nursing

Palavras-Chave #111003 Clinical Nursing - Secondary (Acute Care) #111000 NURSING #Accidental falls #Sensitivity and specificity #Positive and negative predictive values #Aged; Hospitals #Clinical judgement #Screening tools
Tipo

Journal Article