Table 2.
Published Tool | Psychometric Performance Source | Tool Description | Acute Care Dataa | U.S. Datab | Reliability Across Studies | Validity Across Studies |
---|---|---|---|---|---|---|
ADAPT Fall Assessment Tool15 | Individual study15 | ADAPT computerized information system, fall risk embedded into routine assessment documentation, allows customized interventions for specific patient risks, risk information integrated into care plan, report sheets, care conferences | Yes | Yes | n/a | Concurrent validity: risk assessment correlates 0.96 with Hendrich scale scores |
Berryman Predisposition for Falling scale44 (applied to at-risk patients) | Review, data from1 study60 | Assessed domains: age, mental status, length of stay, elimination, falling within the past 6 months, visual impairment, confined to chair, blood pressure | No | Yes | n/a | Face validity: most falls (3 VA patient care units observed for 3 months) were in patients aged ≥70 |
Hendrich, Hendrich II Fall Risk Model / Assessment4,29,33,36,56 | Review, data from 1 study61 | Assessed domains: mental state, gait and mobility, fall history, elimination, diagnosis, continence, mood, dizziness, weakness | Yes | n/a | n/a | Predictive validity: sensitivity 0.77, specificity 0.72 |
I'M SAFE Fall Risk Assessment Tool, Children's Hospital Denver45 | Individual study62 | Assessed domains: environment, history of falls, intravenous medications, orthopedic and muscular, rehabilitation and occupational and physical therapy, seizures andepilepsy | Yes | Yes | Internal consistency (α) 0.69 | n/a |
Innes Score; St Francis Memorial Hospital Standard Care Plan for the High-Risk Patient31,32,48 | Systematic review, data from 1 study63 | Assessed domains: previous trauma, disorientation, impaired judgment, sensory disorientation, muscle weakness, multiple diagnoses, language barrier | n/a | No | n/a | Predictive validity: sensitivity 0.89 (95% CI = 0.78–0.96), specificity 0.74 (95% CI = 0.72–0.75); PPV 0.07 (95% CI = 0.05–0.10), NPV 1.00 (95% CI = 0.99–1.00), OR = 23 (95% CI = 10.1–55.5) |
Morse Falls Scale1,2,6,16,28,39 | Systematic review, data from 4 studies64 | Assessed domains: history of falling, presence of secondary diagnosis, use of ambulatory aids, administration of intravenous therapy, type of gait, mental status | Yes | n/a | n/a | Predictive validity: sensitivity 0.72–0.96, specificity 0.51–0.83 |
Systematic review, data from 2 studies63 | Score of 45 used as cutoff | Yes | No | Predictive validity: sensitivity 0.73–0.96, specificity 0.54–0.75, PPV 0.04–0.10, NPV 0.99–1.00. | ||
Systematic review, data from 3 studies65 | 6 items | Yes | n/a | Interrater agreement 0.96–0.98 | Predictive validity: sensitivity 0.72–0.83, specificity 0.51–0.68 | |
Schmid Fall Risk Assessment Tool49,51 | Systematic review, data from 1 study63 | Assessed domains: gait, confusion, assisted toileting, fall history, anticonvulsants; 5 items; score of 3 used as cutoff | n/a | Yes | n/a | Predictive validity: sensitivity 0.93 (95% CI = 0.80–0.98), specificity 0.78 (95% CI = 0.73–0.83), PPV 0.37 (95% CI = 0.27–0.47), NPV 0.99 (95% CI = 0.96–1.00), OR = 44.3 (95% CI = 13.2–172.4) |
Systematic review, data from 2 studies65 | 17 items; score 3 used as cutoff | Yes | Yes | Interrater agreement 0.88 | Predictive validity: sensitivity 0.91–0.93, specificity 0.25–0.78 | |
Timed Up & Go test17 | Systematic review, data from 1 study65 | Score 10–12 used as cutoff | No | n/a | Interrater agreement 0.56–0.99 | Construct validity: judged as “good” |
Unpublished tool, tool shown and risk factors reported3,13,14,18,20,21,23,26,30,34,37,38,43,47,50,53–55,57,58 | n/a | n/a | n/a | n/a | n/a | n/a |
Tool not described19,40,59 | n/a | n/a | n/a | n/a | n/a | n/a |
No risk assessment5,7–12,22,24,25,27,35,41,42,46,52 | n/a | n/a | n/a | n/a | n/a | n/a |
References in this table are found in the online supporting information.
Tool tested in acute care setting.
Applied in U.S. organization.
n/a = not available, not applicable; VA = Veterans Affairs; ADAPT = Assess: Disorientation, Activity, Postmedication, and Toileting.