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Validity of the Johns Hopkins Fall Risk Assessment Tool for Predicting Falls on Inpatient Medicine Services
W Dean Klinkenberg1, Patricia Potter
1Department of Research for Patient Care Services, Barnes-Jewish Hospital, St. Louis, Missouri (Drs Klinkenberg and Potter).
Journal of Nursing Care Quality
|August 3, 2016
Summary
The Johns Hopkins Fall Risk Assessment Tool (JHFRAT) shows limitations in predicting patient falls. Despite higher scores for those who fell, most were classified as low or moderate risk, questioning its accuracy.
Area of Science:
- Gerontology
- Nursing
- Healthcare Quality
Background:
- The Johns Hopkins Fall Risk Assessment Tool (JHFRAT) is a commonly used clinical instrument.
- Limited research exists on the psychometric properties, specifically predictive validity, of the JHFRAT.
Purpose of the Study:
- To evaluate the predictive validity of the JHFRAT in a large patient cohort.
- To determine the accuracy of the JHFRAT in identifying patients at high risk for falls.
Main Methods:
- Retrospective analysis of 13,574 patient admissions to medicine units.
- Data collected from a large academic medical center in 2014.
- Correlation of JHFRAT scores with 204 reported patient falls.
Main Results:
- Patients who experienced falls had significantly higher JHFRAT total scores compared to those who did not fall.
- However, a majority of patients who fell were categorized by the JHFRAT as being at moderate or low risk.
- This indicates a potential underestimation of fall risk for a substantial number of patients.
Conclusions:
- The JHFRAT may not accurately predict fall risk in all patient populations.
- Further validation and potential refinement of the JHFRAT are warranted.
- Clinical practice may need to supplement JHFRAT scores with other risk assessment methods.
