Spartanburg Fall Risk Assessment Tool: a simple three-step process.

The purpose of this study was to develop a valid, reliable, and user-friendly fall risk assessment tool that is a sensitive predictor for falls in the acute care population. Fall risk factors were determined from extensive review of evidence-based studies available from a PubMed search. Previous falls, medications, and gait were found to be the top three risk factors for predicting a true risk for falls in multiple health care settings. The Spartanburg Fall Risk Assessment Tool (SFRAT) is unique from other fall risk assessment tools in combining intrinsic, patient-related factors, with a direct measure of the patient's functional status. Interrater reliability of the SFRAT using Cohen's kappa was .9008, which reflects almost perfect agreement. The predictability analysis found the SFRAT to be 100% sensitive for falls (27/27) with no false negatives. Specificity was 28% (48/172) with 124 false positives. These false positives may actually reflect patients who were at true risk for fall but were prevented from falling due to effective interventions instituted by the staff providing their care. The SFRAT fall risk assessment is a simple, reliable tool easily incorporated by nurses into their direct care routine.

[1]  D J Eagle,et al.  Comparison of three instruments in predicting accidental falls in selected inpatients in a general teaching hospital. , 1999, Journal of gerontological nursing.

[2]  M. Woollacott,et al.  Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. , 2000, Physical therapy.

[3]  D S Childress,et al.  A preliminary investigation of pelvic obliquity patterns during gait in persons with transtibial and transfemoral amputation. , 2000, Journal of rehabilitation research and development.

[4]  Janice M. Morse Preventing in-patient falls: The nurse's pivotal role. , 2017, Nursing.

[5]  J. C. Gatti Which interventions help to prevent falls in the elderly? , 2002, American Family Physician.

[6]  A. Hendrich,et al.  Hospital falls: development of a predictive model for clinical practice. , 1995, Applied nursing research : ANR.

[7]  Orthopaedic Surgeons Panel On Falls Prevention Guideline for the Prevention of Falls in Older Persons , 2001 .

[8]  Orly Toren,et al.  Characteristics of falls in hospitalized patients. , 2004, Journal of advanced nursing.

[9]  L. Nyberg,et al.  Fall prediction index for patients in stroke , 1997 .

[10]  L Nyberg,et al.  Fall prediction index for patients in stroke rehabilitation. , 1997, Stroke.

[11]  S Gaebler,et al.  Predicting which patient will fall again ... and again. , 1993, Journal of advanced nursing.

[12]  W. Mendelson,et al.  The use of sedative/hypnotic medication and its correlation with falling down in the hospital. , 1996, Sleep.

[13]  Diane Podsiadlo,et al.  The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons , 1991, Journal of the American Geriatrics Society.

[14]  J. Dempsey Falls prevention revisited: a call for a new approach. , 2004, Journal of clinical nursing.

[15]  P. J. Bowman,et al.  Central Nervous System–Active Medications and Risk for Falls in Older Women , 2002, Journal of the American Geriatrics Society.

[16]  U S Nayak,et al.  Balance in elderly patients: the "get-up and go" test. , 1986, Archives of physical medicine and rehabilitation.

[17]  P. Bossuyt,et al.  A Failed Model‐Based Attempt to Implement an Evidence‐Based Nursing Guideline for Fall Prevention , 2003, Journal of nursing care quality.

[18]  M. Vassallo,et al.  Characteristics of Single Fallers and Recurrent Fallers among Hospital In-Patients , 2002, Gerontology.

[19]  S. Nikoletti,et al.  Fall risk assessment : A prospective investigation of nurses' clinical judgement and risk assessment tools in predicting patient falls in an acute care setting , 2003 .

[20]  C. Powers,et al.  Quality Indicators for the Management and Prevention of Falls and Mobility Problems in Vulnerable Elders , 2001, Annals of Internal Medicine.

[21]  Meei-Ling Gau,et al.  Assessing risk of falling in older adults. , 2003, Public health nursing.

[22]  Robert G. Smith Fall-contributing adverse effects of the most frequently prescribed drugs. , 2003, Journal of the American Podiatric Medical Association.

[23]  S L Luther,et al.  Fall risk assessment measures: an analytic review. , 2001, The journals of gerontology. Series A, Biological sciences and medical sciences.

[24]  M. Tinetti Clinical practice. Preventing falls in elderly persons. , 2003, The New England journal of medicine.

[25]  S. Terrell,et al.  Predicting In‐Hospital Falls: Development of the Scott and White Falls Risk Screener , 2005, Journal of nursing care quality.

[26]  J C Wall,et al.  The Timed Get-up-and-Go test revisited: measurement of the component tasks. , 2000, Journal of rehabilitation research and development.

[27]  DOUGLAS G. Smith,et al.  Incidence of falls, risk factors for falls, and fall-related fractures in individuals with diabetes and a prior foot ulcer. , 2002, Diabetes care.

[28]  Johannes Kingma,et al.  Severity of Injuries Due to Accidental Fall across the Life Span: A Retrospective Hospital-Based Study , 2000, Perceptual and motor skills.