Using the Care Dependency Scale for fall risk screening.
OBJECTIVE
This paper is a report of a study conducted to estimate the sensitivity and specificity of the Care Dependency Scale as a measure of risk of falling for individuals in hospital and nursing home settings.


BACKGROUND
Falls and their consequences are common problems in hospitals and nursing homes and nurses should assess the potential risks of their patients. Items in fall risk scales resemble a general nursing assessment, which leads to redundant assessment procedures. It would be beneficial to have a single generic instrument for general assessment and fall risk screening.


METHODS
Standardized questionnaires were used in a cross-sectional study in 2004 and data were gathered from 9943 German nursing home residents and hospital patients (response rate 77.1%). Sensitivity and specificity of all Care Dependency Scale scores were calculated for fall risk. Relationships between the 15 scale items and falls were described using odds ratios and logistic regression analysis.


RESULTS
Patients with falls in hospitals were more care dependent than those without falls. Sensitivity and specificity values showed that with the Care Dependency Scale a differentiation is possible between the falls group and the no-falls group. High odds ratios and logistic regression analysis suggest that the Care Dependency Scale item 'Avoidance of danger' indicated fall risk. Nursing home residents with and without falls had similar care dependency scores.


CONCLUSIONS
Nursing assessment in hospitals could be simplified by using the Care Dependency Scale for fall risk screening. Its value in fall risk screening in nursing homes requires further testing.
Mertens
Elke I
EI
Department of Nursing Science, Centre for the Humanities and Health Science, Charité-Universitätsmedizin Berlin, Berlin, Germany. elke.mertens@charite.de
Halfens
Ruud J G
RJ
Dassen
Theo
T
D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D005851:Geriatric Nursing; D005858:Germany; D006707:Homes for the Aged; D006761:Hospitals; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D009730:Nursing Assessment; D009735:Nursing Homes; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity