2.50
Hdl Handle:
http://hdl.handle.net/10755/344128
Category:
Abstract
Type:
Poster
Title:
Above, Beyond And Over The Siderails! ED Fall Risk Assessment
Author(s):
Scott, Robin; Comer, Jennifer
Lead Author STTI Affiliation:
Non-member
Author Details:
Robin Scott, MS, RN, CEN, robin.scott@uchealth.org; Jennifer Comer, BSN, RN
Abstract:
Research Abstract Purpose: Patient falls lead to the development of co-morbidities, further injury and extended lengths of stay. The Joint Commission requires that all patients be assessed for fall risk and interventions must be put into place to help decrease the risk of patient falls. Until 2013, there was no fall assessment tool designed to meet the special circumstances of emergency department (ED) patients. In March 2013, the Memorial Emergency Department Fall Risk Assessment Tool (MEDFRAT) was published. The MEDFRAT had been studied and implemented in a single institution. This research project is aimed at evaluating the reliability and validity of this new fall risk assessment tool specifically designed for the ED population. Design: This was a prospective tool validation study. Setting: Emergency Department in an academic/teaching institution, 500 bed Level II Trauma Center on pace to see 90,000 patients in FY 2014. Participants/Subjects: Adults (18 years and older) presenting to the ED for care. Anyone under the age of 18 was excluded from study participation. Methods: Phase one sought to determine the interrater reliability of the MEDFRAT. After education and training regarding the MEDFRAT, ED RNs began to complete the MEDFRAT on all ED patients; two independent researchers randomly choose 69 patients to assess for fall risk. The researchers scored the MEDFRAT separately from the ED nurse. Appropriate use of the MEDFRAT tool was also assessed. Six months after education and training of the MEDFRAT, nurses were surveyed regarding how they interpret each question on the MEDFRAT assessment. The nurses’ answers were then used to construct new educational materials. Phase two attempted to assess the validity of the MEDFRAT. The charts of patients whose fall risk was assessed by both an ED RN and one of the independent researchers were retrospectively reviewed after initial assessment to determine if the patient fell during their hospital stay. Results/Outcomes: The kappa statistic (k) showed positive interrater reliability with a k=0.701 indicating substantial agreement between ED nurses and researchers. The actual fall rate of study patients was very low 1.5%; this result however does not lend itself readily to interpretation. There is no data to support if the patient did not fall out of chance or due to the interventions put into place because of the patient’s fall risk score. When looking at survey results of nursing staff, questions regarding how to interpret each item showed good agreement between respondents. Implications: This study highlighted the need to develop more detailed education to accompany the roll out of the new tool. In addition, as the tool is implemented initially, direct 1:1 feedback to staff on correct use of the tool should be instituted. The researchers also felt it would be valuable to include physicians in fall risk education as they are directly at the bedside and able to assess and intervene as necessary. An unexpected finding in this department was the need to make interventions to reduce fall risk more easily accessible at the bedside to eliminate a potential barrier to their use.
Keywords:
ED Falls; ED Risk Assessment
Repository Posting Date:
4-Feb-2015
Date of Publication:
4-Feb-2015
Conference Date:
2014
Conference Name:
2014 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Indianapolis, Indiana, U.S.A.
Description:
2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleAbove, Beyond And Over The Siderails! ED Fall Risk Assessmenten_GB
dc.contributor.authorScott, Robinen_GB
dc.contributor.authorComer, Jenniferen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsRobin Scott, MS, RN, CEN, robin.scott@uchealth.org; Jennifer Comer, BSN, RNen_GB
dc.identifier.urihttp://hdl.handle.net/10755/344128-
dc.description.abstractResearch Abstract Purpose: Patient falls lead to the development of co-morbidities, further injury and extended lengths of stay. The Joint Commission requires that all patients be assessed for fall risk and interventions must be put into place to help decrease the risk of patient falls. Until 2013, there was no fall assessment tool designed to meet the special circumstances of emergency department (ED) patients. In March 2013, the Memorial Emergency Department Fall Risk Assessment Tool (MEDFRAT) was published. The MEDFRAT had been studied and implemented in a single institution. This research project is aimed at evaluating the reliability and validity of this new fall risk assessment tool specifically designed for the ED population. Design: This was a prospective tool validation study. Setting: Emergency Department in an academic/teaching institution, 500 bed Level II Trauma Center on pace to see 90,000 patients in FY 2014. Participants/Subjects: Adults (18 years and older) presenting to the ED for care. Anyone under the age of 18 was excluded from study participation. Methods: Phase one sought to determine the interrater reliability of the MEDFRAT. After education and training regarding the MEDFRAT, ED RNs began to complete the MEDFRAT on all ED patients; two independent researchers randomly choose 69 patients to assess for fall risk. The researchers scored the MEDFRAT separately from the ED nurse. Appropriate use of the MEDFRAT tool was also assessed. Six months after education and training of the MEDFRAT, nurses were surveyed regarding how they interpret each question on the MEDFRAT assessment. The nurses’ answers were then used to construct new educational materials. Phase two attempted to assess the validity of the MEDFRAT. The charts of patients whose fall risk was assessed by both an ED RN and one of the independent researchers were retrospectively reviewed after initial assessment to determine if the patient fell during their hospital stay. Results/Outcomes: The kappa statistic (k) showed positive interrater reliability with a k=0.701 indicating substantial agreement between ED nurses and researchers. The actual fall rate of study patients was very low 1.5%; this result however does not lend itself readily to interpretation. There is no data to support if the patient did not fall out of chance or due to the interventions put into place because of the patient’s fall risk score. When looking at survey results of nursing staff, questions regarding how to interpret each item showed good agreement between respondents. Implications: This study highlighted the need to develop more detailed education to accompany the roll out of the new tool. In addition, as the tool is implemented initially, direct 1:1 feedback to staff on correct use of the tool should be instituted. The researchers also felt it would be valuable to include physicians in fall risk education as they are directly at the bedside and able to assess and intervene as necessary. An unexpected finding in this department was the need to make interventions to reduce fall risk more easily accessible at the bedside to eliminate a potential barrier to their use.en_GB
dc.subjectED Fallsen_GB
dc.subjectED Risk Assessmenten_GB
dc.date.available2015-02-04T11:27:00Z-
dc.date.issued2015-02-04-
dc.date.accessioned2015-02-04T11:27:00Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationIndianapolis, Indiana, U.S.A.en_GB
dc.description2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_GB
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