Fall Model May Not Be Reliable for Emergency Department

Inpatient risk model does not identify those most at risk
By Jane Parry
HealthDay Reporter

THURSDAY, March 19 (HealthDay News) -- The risk model that helps identify those at risk of falls in an inpatient setting may not be reliable in predicting those at risk in the emergency department, researchers report in the March issue of the Journal of Emergency Nursing.

Kevin M. Terrell, of Indiana University School of Medicine in Indianapolis, and colleagues conducted a review of the medical records of 57 patients who suffered a fall while in a hospital emergency department and used the Hendrich II Fall Risk Model to see if it could identify those most at risk.

The number of falls represented 0.288 falls per 1,000 patient visits, and the average age of the patients who had a fall was 50 years, the data revealed. When eight risk parameters from the Hendrich model were applied, 21 of the patients had a score of 5 or more, indicating the model had 37.5 percent sensitivity. The researchers found that 11 (19.6 percent) of the subjects were experiencing alcohol intoxication and 11 had taken potentially sedating medication before they fell.

"Because of important differences between falls in inpatients and emergency department patients, it may be necessary to develop an emergency department-specific fall model," the authors write. "Until such a model is developed and validated, we recommend use of Hendrich II risk factors, in addition to intoxication and receipt of potentially sedating medications."

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