Memorial Emergency Department Fall Risk Assessment Tool: Identifies Substantially More At-Risk Emergency Department...

Area of Science:

• Emergency Medicine
• Quality Improvement
• Nursing Practice

Background:

• Fall-risk screening in emergency departments (EDs) is difficult due to transient patient changes.
• Existing inpatient tools may miss ED-specific fall risk states.
• A quality improvement project compared two fall risk assessment tools in the ED.

Purpose of the Study:

• To evaluate if the Memorial Emergency Department Fall Risk Assessment Tool identifies more at-risk encounters than the Schmid Fall Risk Assessment Tool.
• To assess the effectiveness of an ED-specific fall risk screening tool.

Main Methods:

• A paired-comparison quality improvement project in an adult ED.
• Retrospective chart audits of paired tool classifications.
• Fall risk defined as a score of 3 or higher; McNemar's test for discordant classifications.

Main Results:

• The Memorial tool identified 55.7% of encounters as at-risk versus 28.5% for Schmid.
• Significantly more discordant classifications favored the Memorial tool (348 vs. 25).
• Matched-pair odds ratio was 13.92 (P<.001).

Conclusions:

• The Memorial ED Fall Risk Assessment Tool substantially outperformed Schmid in identifying at-risk encounters.
• An ED-specific screening approach improves recognition of transient fall risks.
• Supports enhanced emergency nursing practice for fall prevention.