Evaluating a Fall Risk Assessment Tool in an Emergency Department

A hospital's emergency department (ED) used the Johns Hopkins fall risk assessment tool (JHFRAT), which was not developed to assess the ED patients. The ED committee recommended the memorial ED fall risk assessment tool (MEDFRAT) plus a "nursing judgment" category. However, the modified MEDFRAT needed to be evaluated before implementation. This research evaluated the modified MEDFRAT in ED patients and nurses' perception of the tool.

A two-stage quantitative design was used. Stage 1 was a chart review using both tools for patients who fell (n = 57) in the past 4 years and the control patients (n = 57). Two tools were compared using t-tests, Bland-Altman, predictive abilities, and mismatch rates. Stage 2 was the assessment of all ED patients (n = 435) seen by the ED triage nurses for 1 week using both tools. The chi-squared test and mismatch rates were used to compare the tools. Time to complete both tools and nurses' perceptions to the modified MEDFRAT were analyzed.

Two tools were significantly different. The modified MEDFRAT had higher predictive ability and lower mismatch rates than the JHFRAT. It needed shorter time to complete and was preferred by most nurses.

The modified MEDFRAT is adequate to use in the ED.