How to try this: predicting patient falls. Using the Hendrich II Fall Risk Model in clinical practice.

Ascension Health, St Louis, USA.
The American Journal of Nursing (Impact Factor: 1.3). 12/2007; 107(11):50-8; quiz 58-9.
Source: PubMed
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    • "Today, there is a consensus definition of falls [8]. Several risk assessment tools are available to assess a hospitalised [9,10] or community-dwelling [11,12] patient’s risk of falling. The tools assess different clinical characteristics as confusion, dizziness, cognitive impairment or administered drugs. "
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    ABSTRACT: Falls are the most common cause of injuries and hospital admissions in the elderly. The Swedish National Board of Health and Welfare has created a list of drugs considered to increase the fall risk (FRIDs) and drugs that might cause/worsen orthostatism (ODs). This cross-sectional study was aimed to assess FRIDs and their correlation with falls in a sample of 369 community-dwelling and nursing home patients aged >=75 years and who were using a multi-dose drug dispensing system. Data were collected from the patients' electronic medication lists. Retrospective data on reported falls during the previous three months and severe falls during the previous 12 months were collected. Primary outcome measures were incidence of falls as well as numbers of FRIDs and ODs in fallers and non-fallers. The studied sample had a high incidence of both reported falls (29%) and severe falls (17%). Patients were dispensed a mean of 2.2 (SD 1.5) FRIDs and 2.0 (SD 1.6) ODs. Fallers used on average more FRIDs. Severe falls were more common in nursing homes patients. More women than men experienced severe falls. There were positive associations between number of FRIDs and the total number of drugs (p < 0.01), severe falls (p < 0.01) and female sex (p = 0.03). There were also associations between number of ODs and both total number of drugs (p < 0.01) and being community dwelling (p = 0.02). No association was found between number of ODs and severe falls. Antidepressants and anxiolytics were the most frequently dispensed FRIDs. Fallers had a higher number of FRIDs. Numbers of FRIDs and ODs were correlated with the total number of drugs dispensed. Interventions to reduce falls in the elderly by focusing on reducing the total number of drugs and withdrawal of psychotropic medications might improve the quality and safety of drug treatment in primary care.
    BMC Geriatrics 03/2014; 14(1):40. DOI:10.1186/1471-2318-14-40 · 1.68 Impact Factor
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    • "The score ranges from 0 to 16, where 16 represents the highest risk. The patient is considered at high risk of falling if the score is 5 or higher (Hendrich, 2007). To facilitate the compilation for the Italian nurses, we listed the trade name of the most used antiepileptic and benzodiazepine drugs instead of the substance names, as in Italian hospital the trade names are more commonly used to identify the drug prescriptions. "
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    ABSTRACT: Falls are the most common adverse events reported in acute care hospitals, and older patients are the most likely to fall. The risk of falling cannot be completely eliminated, but it can be reduced through the implementation of a fall prevention program. A major evidence-based intervention to prevent falls has been the use of fall-risk assessment tools. Many tools have been increasingly developed in recent years, but most instruments have not been investigated regarding reliability, validity and clinical usefulness. This study intends to evaluate the predictive validity and inter-rater reliability of Hendrich fall risk model II (HFRM II) in order to identify older patients at risk of falling in geriatric units and recommend its use in clinical practice. A prospective descriptive design was used. The study was carried out in a geriatric acute care unit of an Italian University hospital. All over 65 years old patients consecutively admitted to a geriatric acute care unit of an Italian University hospital over 8-month period were enrolled. The patients enrolled were screened for the falls risk by nurses with the HFRM II within 24h of admission. The falls occurring during the patient's hospital stay were registered. Inter-rater reliability, area under the ROC curve, sensitivity, specificity, positive and negative predictive values and time for the administration were evaluated. 179 elderly patients were included. The inter-rater reliability was 0.87 (95% CI 0.71-1.00). The administration time was about 1min. The most frequently reported risk factors were depression, incontinence, vertigo. Sensitivity and specificity were respectively 86% and 43%. The optimal cut-off score for screening at risk patients was 5 with an area under the ROC curve of 0.72. The risk factors more strongly associated with falls were confusion and depression. As falls of older patients are a common problem in acute care settings it is necessary that the nurses use specific validate and reliable fall risk assessment tools in order to implement the most effective prevention measures. Our findings provided supporting evidence to the choice of the HFRM II to screen older patients at risk of falling in acute care settings.
    International journal of nursing studies 10/2010; 48(4):468-74. DOI:10.1016/j.ijnurstu.2010.09.002 · 2.90 Impact Factor
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    • "Some falls were unrelated to hospital activities but were associated with the child's developmental age, such as falls on the hospital playgrounds. Hendrich (2007) indicated that in the pediatric population (younger than 10 years), the majority of falls correlate with environmental conditions such as cribs, rails, playrooms , and well intentioned but forgetful parents who leave children unattended or the side rail down while a child is alone. The number one strategy, according to Hendrich, is to integrate injury prevention messages with developmental assessment of the child. "
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    ABSTRACT: The purpose of this descriptive study was to assess whether the Humpty Dumpty Falls Scale (HDFS) identifies hospitalized pediatric patients at high risk for falls. The study was a matched case-control design. A chart review of 153 pediatric cases who fell and 153 controls who did not fall were pair-matched by age, gender, and diagnosis. High-risk patients fell almost twice as often as low-risk patients (odds ratio 1.87, confidence interval = 1.01, 3.53, p = .03). A Falls Prevention Pediatric Program with the HDFS tool addresses the Joint Commission Patient Safety Goals, but further research is needed to examine HDFS sensitivity-specificity.
    Journal for Specialists in Pediatric Nursing 02/2009; 14(1):22-32. DOI:10.1111/j.1744-6155.2008.00166.x · 0.92 Impact Factor
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