A Comparative Study Of Three Fall Risk Assessment Tools For Elderly Inpatients

Objective: In order to provide a reliable,effective and practical basis for the selection of fall risk assessment tools for elderly inpatients,the evaluation time,inter-rater reliability,correlation of evaluation results,nurses’ evaluation and nurses’ first choice were compared between the Morse Fall Scale,the Hendrich Fall Risk Model and the St Thomas’ S Risk Assessment Tool in Falling Elderly Inpatients.Methods: 1.Assessment of scale: elderly inpatients from the Department of Neurology and General Surgery of two Three-A hospitals were selected.Within 24 hours of admission,both the general data of the patients and the assessment of the Morse Fall Scale,the Hendrich Fall Risk Model and the St Thomas’ S Risk Assessment Tool in Falling Elderly Inpatients were finished,and the time of assessment was recorded.2.Assessment of inter-rater reliability: the fall risk of 30 patients were evaluated by the researcher and two qualified trained assistants simultaneously,the interval is less than 24 hours.3.The nurse’s assessment: clinical nurses in geriatric ward of a Three-A hospital were selected.The nurses evaluated the feasibility and clinical practicability of the three scales.4.Statistical analysis: SPSS 21.0 was used for statistical analysis.Kruskal-Wallis H test was used for inter-group difference,Intraclass Correlation Coefficient(ICC)was used to calculate inter-rater reliability of the three scales,and Spearman Correlation Coefficient was used to analyze the correlation of the assessment results of the three scales.Whenα=0.05 was used as the test level.Results: A total of 144 patients were included in this study.1.The time of assessment of the Morse Fall Scale,the St Thomas’ S Risk Assessment Tool in Falling Elderly Inpatients and the Hendrich Fall Risk Model time were 34(26,45)(s)、53(42,66)(s)and 39(27.75,52.25)(s)respectively.The time of Morse Fall Scale and the St Thomas’ S Risk Assessment Tool in Falling Elderly Inpatients was lower than that of the Hendrich Fall Risk Model(P < 0.001).The time of Morse Fall Scale was slightly lower than St Thomas’ S Risk Assessment Tool in Falling Elderly Inpatients,but there was no statistical difference between them(P = 0.19).2.The correlation coefficient of the St Thomas’ S Risk Assessment Tool in Falling Elderly Inpatients with the Morse Fall Scale and the Hendrich Fall Risk Model were 0.632 and0.658 respectively,and that of the Morse Fall Scale and the Hendrich Fall Risk Model were 0.453(P < 0.01).3.The inter-rater reliability of the Morse Fall Scale,the Hendrich Fall Risk Model and the St Thomas’ S Risk Assessment Tool in Falling Elderly Inpatients were 0.898,0.934 and0.809 respectively.4.The total scores of the feasibility and clinical practicability of the St Thomas’ S Risk Assessment Tool in Falling Elderly Inpatients,the Morse Fall Scale and the Hendrich Fall Risk Model were 31.20±4.44,30.70±4.98,and 29.90±5.20,respectively.Among the 10 nurses,7 nurses chose the Morse Fall Scale as the preferred scale,2 nurses chose the St Thomas’ S Risk Assessment Tool in Falling Elderly Inpatients Thomas fall risk assessment tool as the preferred scale,and only one nurse chose the Hendrich Fall Risk Model as the preferred scale.Conclusion: The time of assessment of the Morse Fall Scale is the shortest,which can reduce the clinical workload.The scale also has good inter-rater reliability,the assessment results are stable when used by different evaluators.Moreover,the assessment results of the scale was significantly correlated with these of the other two scales,and the scale’s first choice rate was the highest.Based on these,the study recommends the Morse Fall Scale for the fall risk assessment in elderly inpatients.