Screening the risk of falls: a general or a specific instrument?
OBJECTIVE
The aim of this study is to investigate if a general instrument (Care Dependency Scale; CDS) has the same sensitivity and specificity as a specific instrument (Hendrich Fall Risk Model; HFRM) in a screening for fall risks.


BACKGROUND
Falls of older patients are a common problem in hospitals. Apart from falls risk, nurses have to use many assessment tools to detect the patients' different care problems. To decrease the workload it would be helpful to have a general instrument used as a first screening for possible risks for different healthcare problems, such as falls, instead of specific risk instruments for each individual healthcare problem.


METHODS
A prospective design was used by measuring each patient upon admission and by registering all falls during their hospital stay.


METHODS
The sample consisted of 560 patients of a geriatric hospital in Germany. All of whom gave their informed consent to participate in the study. Nurses filled in the CDS and the HFRM at the time of hospital admission.


RESULTS
The CDS (cut off point <or=54) had a sensitivity of 75% (47/63 fallers) and a specificity of 46% (227/497 non-fallers). The HFRM (cut off point >or=11) had a sensitivity of 75% (47/63 fallers) and a specificity of 47% (237/497 non-fallers).


CONCLUSIONS
The results of the CDS are similar to those of the HFRM in predicting falls. Relevance to clinical practice. The use of the CDS is preferred as it is more general and more reliable than the HFRM. The workload for nursing staff can be decreased when only one instrument is used.
Heinze
Cornelia
C
Department of Nursing Science, Charité Universitätsmedizin Berlin, Berlin, Germany. cornelia.heinze@charite.de
Dassen
Theo
T
Halfens
Ruud
R
Lohrmann
Christa
C
D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000368:Aged; D005260:Female; D005853:Geriatrics; D005858:Germany; D006801:Humans; D008297:Male; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity