Comparison of three fall risk assessment tools in older hospitalized patients in Turkey: analysis of sensitivity and specificity

Evaluation of different fall risk screening tools for risk prediction of ophthalmology inpatients

AIMS AND OBJECTIVES

To evaluate the risk factors for falls in adult ophthalmic inpatients and compare the accuracy and predictability of fall risk screening tools.

METHODS

A prospective cross-sectional study was conducted on a total of 1102 hospitalised patients in ophthalmology ward. Fall risk screening was performed within 8 h of admission using the following tools: Falling Risk Assessment Tool in Ophthalmology Inpatients (FRAT), Morse Fall Scale (MFS), Johns Hopkins fall-risk Assessment Tool (JHFRAT), St Thomas Risk Assessment Tool (STRATIFY), and Hendrich II fall-risk Model (HFRM). Taking the occurrence of falls or the occurrence of falls as a positive standard. The sensitivity, specificity, positive predictive value, negative predictive value and area under the curve of the risk assessment tool were calculated to determine accuracy and predictability.

RESULTS

In this study, 1102 met the inclusion criteria. The mean age was 56.81(58.00) and 536(48.6) were females. 61(5.54%) experienced falling or falling status. STRATIFY had the highest sensitivity(85.2%), followed by FRAT(70.5%). The specificity of MFS was the highest(91.7%), followed by FRAT(69.5%). However, in clinical practice, risk assessment tools are difficult to have high sensitivity and high specificity, so they are more inclined to high-sensitivity assessment tools to avoid missing high-risk groups. According to the evaluation results, FRAT has both good sensitivity and specificity. Furthermore, we identified significant risk factors for falls in ophthalmic patients, such as fall history, visual acuity, age, excretion and gait.

CONCLUSIONS

FRAT was the most suitable fall assessment tool and was essential for reliable screening of people at high risk of ophthalmic falls.

PATIENT OR PUBLIC CONTRIBUTION

After explaining the purpose, the patients received our fall risk assessment and answered the corresponding questionnaire questions.

Investigation of factors associated with pressure ulcer in patients receiving home care services via path analysis

BACKGROUND

Recent trends indicate a rise in the number of elderly and bedridden patients enrolled in home care programs, leading to an increased occurrence of complications such as pressure ulcers within the home health care setting.

OBJECTIVE

The primary objective of this research was to ascertain the prevalence of pressure ulcers and identify the associated factors in adults who were recipients of home health care services.

METHOD

This study, adopting a cross-sectional design, encompassed a sample of 566 patients who sought services from the Home Health Care Unit in a specific province in Turkey. The timeframe for data collection spanned from August to November 2022, during which two primary instruments were employed: the "Demographic Characteristics Form" and two specific scales - the "Braden Pressure Ulcer Risk Assessment Scale" and the "ITAKI Falls Risk Scale."

FINDINGS

In this study, the average age of patients receiving home health care services was identified as 75.9 years, with a standard deviation of 15.1 years. Furthermore, 73.7 % of these patients were classified as being at risk for developing pressure ulcers. The study identified a direct correlation between the risk of BRADEN pressure ulcers and the escalation in scores across several parameters. These parameters included "Addiction Status," delineated as a spectrum from addicted to non-addicted, the "Number of Medical Diagnoses," quantified on a scale, the "State of Consciousness," categorized from clear to confused, and the scores derived from the "ITAKI" scale.

CONCLUSION

The findings of this study highlight the significance of pressure ulcers as a critical health issue among patients receiving home care services. It underscores the necessity for home care nurses to be acutely aware of the risk factors associated with pressure ulcers among high-risk patients.

Nurses' perspectives on inpatient falls in a large academic hospital in South Africa

BACKGROUND

Falls risk assessment tools, including the Morse Falls Scale, have been used for years, and yet falls remain key adverse events in hospitals. Nurses are key role players in falls prevention and can champion patient safety.

OBJECTIVES

The aim of the study was to explore ward nurses' attitudes, knowledge and practices regarding the use of falls risk assessment tools, institutional falls policy and falls prevention.

METHODS

A survey design was used. All permanent ward nurses were eligible to participate, and a convenience sample was used.

RESULTS

Nurses endorsed the Morse Falls Scale, recommended by institutional policy, as effective in reducing falls and indicated that incident reporting measured progress on monitoring fall events. Falls prevention training was scanty; however, nurses were keen for further education of falls.

CONCLUSION

Effective falls risk management needs to extend beyond promulgating policy and actively address nursing and patient education.Contribution: This study adds to the sparse literature regarding nursing practice and falls prevention in a developing country. Recommendations for change have been made.