Fall prediction according to nurses' clinical judgment: differences between medical, surgical, and geriatric wards

Milisen, Koen and Coussement, Joke and Flamaing, Johan and Vlaeyen, Ellen and Schwendimann, René and Dejaeger, Eddy and Surmont, Kurt and Boonen, Steven. (2012) Fall prediction according to nurses' clinical judgment: differences between medical, surgical, and geriatric wards. Journal of the American Geriatrics Society, 60 (6). pp. 1115-1121.

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Official URL: https://edoc.unibas.ch/62344/

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To assess the value of nurses' clinical judgment (NCJ) in predicting hospital inpatient falls.; Prospective multicenter study.; Six Belgian hospitals.; Two thousand four hundred seventy participants (mean age 67.6 ± 18.3; female, 55.7%) on four surgical (n = 812, 32.9%), eight geriatric (n = 666, 27.0%), and four general medical wards (n = 992, 40.1%) were included upon admission. All participants were hospitalized for at least 48 hours.; Within 24 hours after admission, nurses gave their judgment on the question "Do you think your patient is at high risk for falling?" Nurses were not trained in assessing fall risk. Falls were documented on a standardized incident report form.; During hospitalization, 143 (5.8%) participants experienced one or more falls, accounting for 202 falls and corresponding to an overall rate of 7.9 falls per 1,000 patient days. NCJ of participant's risk of falling had high sensitivity (78-92%) with high negative predictive value (94-100%) but low positive predictive value (4-17%). Although false-negative rates were low (8-22%) for all departments and age groups, false-positive rates were high (55-74%), except on surgical and general medical wards and in participants younger than 75.; This analysis, based on multicenter data and a large sample size, suggests that NCJ can be recommended on surgical and general medical wards and in individuals younger than 75, but on geriatric wards and in participants aged 75 and older, NCJ overestimates risk of falling and is thus not recommended because expensive comprehensive fall-prevention measures would be implemented in a large number of individuals who do not need it.
Faculties and Departments:03 Faculty of Medicine > Departement Public Health > Institut für Pflegewissenschaft
UniBasel Contributors:Schwendimann, René
Item Type:Article, refereed
Article Subtype:Research Article
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:03 Aug 2020 12:12
Deposited On:03 Aug 2020 12:12

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