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

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.

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Abstract

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.

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ID Code: 26112
Item Type: Journal Article
Additional URLs:
Keywords: Accidental falls, Sensitivity and specificity, Positive and negative predictive values, Aged; Hospitals, Clinical judgement, Screening tools
DOI: 10.1016/j.jclinepi.2009.02.003
ISSN: 0895-4356
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Clinical Nursing - Secondary (Acute Care) (111003)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000)
Divisions: Current > Research Centres > Centre for Health Research
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Copyright Owner: Elsevier Inc. All rights reserved.
Deposited On: 03 Jul 2009 13:01
Last Modified: 29 Feb 2012 23:59

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