Adding value to the STRATIFY falls risk assessment in acute hospitals

Area of Science:

• Gerontology and Geriatric Medicine
• Nursing and Healthcare Quality

Background:

• Falls risk assessment is crucial for effective fall prevention strategies in healthcare settings.
• Evaluating the clinimetric properties of assessment tools is essential before clinical implementation.

Purpose of the Study:

• To compare the predictive accuracy of The Northern Hospital Modified St Thomas's Risk Assessment Tool against the original St Thomas's Risk Assessment Tool for identifying fallers.
• To assess and compare the inter-rater agreement for both the modified and original risk assessment tools.

Main Methods:

• A prospective cross-sectional study was conducted with acute hospital patients.
• Phase I: Predictive accuracy was evaluated using sensitivity, specificity, and Youden Index (J) on 263 patients.
• Phase II: Inter-rater agreement was assessed using the Kappa statistic (κ) on 52 patients.

Main Results:

• The Northern Hospital Modified St Thomas's Risk Assessment Tool exhibited higher sensitivity (0.65 vs. 0.35) and overall accuracy (J=0.44 vs. J=0.28) compared to the original tool.
• The original St Thomas's Risk Assessment Tool showed higher specificity (0.93 vs. 0.79).
• Inter-rater agreement was fair for the modified tool (κ=0.34) and low for the original tool (κ=0.19).

Conclusions:

• Both tools accurately identified patients at risk of falling, but the modified tool demonstrated superior predictive accuracy.
• The Northern Hospital Modified St Thomas's Risk Assessment Tool offers improved reliability for clinical use.
• Further research is required to validate the impact of falls risk assessment tools on reducing patient falls.