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A Roadmap for Practice-Based Evidence: Validation of the Hester Davis Fall Risk Scale
Jennifer Kaiser1, Nicole Wills, Therese Reilly
1Nursing Practice and Development (Dr Kaiser), Nursing Administration, Orthopedics and Neuroscience (Ms Wills), Corporate Quality Improvement (Ms Reilly), Medical/Surgical Gastrointestinal/Genitourinary (Mss Pratt and Niemeyer), Neuroscience (Ms Tumbleson), and Trauma and Orthopedic Reconstruction (Ms Mindling), Spectrum Health, Grand Rapids, Michigan.
Organizations should validate fall risk tools in their own patient populations. This study found the Hester Davis tool had minimal predictive ability in its sample, highlighting the need for local assessment.
Area of Science:
- Healthcare quality improvement
- Clinical risk assessment
Background:
- Evidence-based practice integration requires validation of tools in the target population and setting.
- Implementing new interventions necessitates confirming their efficacy and applicability locally.
Purpose of the Study:
- To present a method for evaluating the predictive performance of a clinical risk assessment tool.
- To demonstrate this method using the Hester Davis fall risk tool as a case study.
Main Methods:
- A retrospective, matched-pairs analysis was conducted comparing fallers and non-fallers.
- Psychometric properties of the Hester Davis tool were calculated using 2x2 contingency tables.
- The tool's performance was compared against original validation data.
Main Results:
- The Hester Davis fall risk tool demonstrated limited ability to differentiate between patients at high and low risk of falling within this specific study sample.
- The tool's predictive performance in this cohort was significantly lower than reported in its original validation.
Conclusions:
- Healthcare organizations must independently validate risk assessment tools within their unique patient populations.
- This study offers a practical framework for assessing the real-world performance of evidence-based tools before widespread implementation.
