Evaluating a Fall Risk Assessment Tool in an Emergency Department

Area of Science:

• Emergency Medicine
• Nursing Research
• Patient Safety

Background:

• The Johns Hopkins Fall Risk Assessment Tool (JHFRAT) was not originally designed for emergency department (ED) patients.
• A modified Memorial ED Fall Risk Assessment Tool (MEDFRAT), including nursing judgment, was proposed for ED use but required evaluation.

Purpose of the Study:

• To evaluate the modified MEDFRAT's effectiveness in assessing fall risk in ED patients.
• To assess ED nurses' perceptions of the modified MEDFRAT.

Main Methods:

• A two-stage quantitative design was employed, including a retrospective chart review of patients who fell and a prospective week-long assessment of ED patients.
• The modified MEDFRAT and JHFRAT were compared using statistical tests (t-tests, chi-squared), Bland-Altman analysis, predictive abilities, and mismatch rates.
• Data on tool completion time and nurses' perceptions of the modified MEDFRAT were also collected.

Main Results:

• The modified MEDFRAT demonstrated significantly higher predictive ability and lower mismatch rates compared to the JHFRAT.
• The modified MEDFRAT required less time to complete than the JHFRAT.
• Most nurses preferred the modified MEDFRAT, indicating positive perceptions.

Conclusions:

• The modified MEDFRAT is a suitable and effective tool for fall risk assessment in the emergency department setting.
• The inclusion of nursing judgment enhances the tool's applicability and acceptance among ED nurses.