Fall prevention : is the STRATIFY tool the right instrument in Italian Hospital inpatient? A retrospective observational study
Articolo
Data di Pubblicazione:
2017
Citazione:
Fall prevention : is the STRATIFY tool the right instrument in Italian Hospital inpatient? A retrospective observational study / G. Castellini, A. Demarchi, M. Lanzoni, S. Castaldi. - In: BMC HEALTH SERVICES RESEARCH. - ISSN 1472-6963. - 17:1(2017 Sep 15), pp. 656.1-656.7. [10.1186/s12913-017-2583-7]
Abstract:
Background: Although several risk assessment tools are in use, uncertainties on their accuracy in detecting fall risk
already exist. Choosing the most accurate tool for hospital inpatient is still a challenge for the organizations. We
aimed to retrospectively assess the appropriateness of a fall risk prevention program with the STRATIFY assessment
tool in detecting acute-care inpatient fall risk.
Methods: Number of falls and near falls, occurred from January 2014 to March 2015, was collected through the
incident reporting web-system implemented in the hospital’s intranet. We reported whether the fall risk was assessed
with the STRATIFY assessment tool and, if so, which was the judgement. Primary outcome was the proportion of
inpatients identified as high risk of fall among inpatients who fell (True Positive Rate), and the proportion of inpatients
identified as low-risk that experienced a fall howsoever (False Negative Rate). Characteristics of population and fall
events were described among subgroups of low risk and high risk inpatients.
Results: We collected 365 incident reports from 40 hospital units, 349 (95.6%) were real falls and 16 (4.4%) were near
falls. The fall risk assessment score at patient’s admission had been reported in 289 (79%) of the overall incident reports.
Thus, 74 (20.3%) fallers were actually not assessed with the STRATIFY, even though the majority of them presented risk
recommended to be assessed. The True Positive Rate was 35.6% (n = 101, 95% CI 30% - 41.1%). The False Negative
Rate was 64.4% (n = 183, 95% CI 58.9%–70%) of fallers, nevertheless they incurred in a fall. The STRATIFY mean score
was 1.3 ± 1.4; the median was 1 (IQQ 0–2).
Conclusions: The prevention program using only the STRATIFY tool was found to be not adequate to screen our
inpatients population. The incorrect identification of patients’ needs leads to allocate resources to erroneous priorities
and to untargeted interventions, decreasing healthcare performance and quality.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
accidental falls; incident reporting; patient safety; risk assessment tools
Elenco autori:
G. Castellini, A. Demarchi, M. Lanzoni, S. Castaldi
Link alla scheda completa: