Risk Assessment Tool for the Prediction of fall

Abstract

An effective tool for the prediction of fall risk among the patients admitted in wards requires high sensitivity with specificity, good predictive value and easy to use in the clinical practice. Objective of the study is to develop fall risk assessment tool. Study was done on patients admitted at MMIMS&R Hospital, Mullana, Ambala and Methodological approach was used. From related review of literature, experts' guidance and investigators' personal experience, a list of risk factors were identified and compared with standardized risk assessment scales i.e. Morse Fall Scale & Fall Risk Assessment & Screening Tool i.e FRAST. Content validity was ascertained by expert's opinion & was found to be 0.94. The range of rating score was 12 to 48, with the assumption that higher the scores, the greater the risk of falls. At a cut-off point of ≥ 18, the best balance between the sensitivity and specificity was achieved, i.e. sensitivity was 26.42%, specificity 85.71%, predictive value positive 26 % and predictive value negative 74%. Cronbach's alpha and item item Correlation were used to measure the internal consistency of the tool, Coefficient alpha was 0.75, statistically significant at 0.001 levels. Item-item correlations were moderate (between 0.30 to 0.70) among most of the items. In order to estimate equivalence Inter-rater reliability method was used & percentage of agreement between raters was 84%. Concurrent validity of fall risk assessment tool was checked by calculating Pearson correlation in between the fall risk assessment tool and Morse Fall Scale & was found to be 0.70.