The reliability of the Hendrich Fall Risk Model in a geriatric hospital

Aims and objectives.  The purpose of this study was to test the interrater reliability of the Hendrich Fall Risk Model, an instrument to identify patients in a hospital setting with a high risk of falling. Background.  Falls are a serious problem in older patients. Valid and reliable fall risk assessment tools are required to identify high-risk patients and to take adequate preventive measures. Methods.  Seventy older patients were independently and simultaneously assessed by six pairs of raters made up of nursing staff members. Consensus estimates were calculated using simple percentage agreement and consistency estimates using Spearman's rho and intra class coefficient. Results.  Percentage agreement ranged from 0.70 to 0.92 between the six pairs of raters. Spearman's rho coefficients were between 0.54 and 0.80 and the intra class coefficients were between 0.46 and 0.92. Conclusions.  Whereas some pairs of raters obtained considerable interobserver agreement and internal consistency, the others did not. Therefore, it is concluded that the Hendrich Fall Risk Model is not a reliable instrument. The use of more unambiguous operationalized items is preferred. Relevance to clinical practice.  In practice, well operationalized fall risk assessment tools are necessary. Observer agreement should always be investigated after introducing a standardized measurement tool.