The STRATIFY tool and clinical judgment were poor predictors of falling in an acute hospital setting

Webster, Joan, Courtney, Mary, Marsh, Nicole, Gale, Catherine, Abbott, Belynda, MacKenzie-Ross, Anita and McRae, Prue (2010) The STRATIFY tool and clinical judgment were poor predictors of falling in an acute hospital setting. Journal of Clinical Epidemiology, 63 1: 109-113. doi:10.1016/j.jclinepi.2009.02.003

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Author Webster, Joan
Courtney, Mary
Marsh, Nicole
Gale, Catherine
Abbott, Belynda
MacKenzie-Ross, Anita
McRae, Prue
Title The STRATIFY tool and clinical judgment were poor predictors of falling in an acute hospital setting
Journal name Journal of Clinical Epidemiology   Check publisher's open access policy
ISSN 0895-4356
1878-5921
Publication date 2010-01
Year available 2009
Sub-type Article (original research)
DOI 10.1016/j.jclinepi.2009.02.003
Volume 63
Issue 1
Start page 109
End page 113
Total pages 5
Place of publication Philadelphia, PA, United States
Publisher Elsevier
Collection year 2011
Language eng
Formatted abstract
Objective: To compare the effectiveness of the STRATIFY falls tool with nurses' clinical judgments in predicting patient falls.
Study Design and Setting: A prospective cohort study was conducted among the inpatients of an acute tertiary hospital. Participants were patients over 65 years of age admitted to any hospital unit. Sensitivity, specificity, and positive predictive value (PPV) and negative predictive values (NPV) of the instrument and nurses' clinical judgments in predicting falls were calculated.
Results: Seven hundred and eighty-eight patients were screened and followed up during the study period. The fall prevalence was 9.2%. Of the 335 patients classified as being "at risk" for falling using the STRATIFY tool, 59 (17.6%) did sustain a fall (sensitivity = 0.82, specificity = 0.61, PPV = 0.18, NPV = 0.97). Nurses judged that 501 patients were at risk of falling and, of these, 60 (12.0%) fell (sensitivity = 0.84, specificity = 0.38, PPV = 0.12, NPV = 0.96). The STRATIFY tool correctly identified significantly more patients as either fallers or nonfallers than the nurses (P = 0.027).
Conclusion: Considering the poor specificity and high rates of false-positive results for both the STRATIFY tool and nurses' clinical judgments, we conclude that neither of these approaches are useful for screening of falls in acute hospital settings.
© 2010 Elsevier Inc. All rights reserved.
Keyword Accidental falls
Sensitivity and specificity
Positive and negative predictive values
Aged
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Additional Notes Available online 23 April 2009

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
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