Fall risk assessment measures: An analytic review

Background. Clinicians are often unaware of the many existing scales for id entifying fall risk and are uncertain about how to select an appropriate on e. Our purpose was to summarize existing fall risk assessment scales to ena ble more informed choices regarding their use. Methods. After a systematic literature search, 21 articles published from 1 984 through 2000 describing 20 fall risk assessments were reviewed independ ently for content and validation by a panel of five reviewers using a stand ardized review form. Fourteen were institution-focused nursing assessment s cales, and six were functional assessment scales. Results. The majority of the scales were developed for elderly populations. mainly in hospital or nursing home settings. The patient characteristics a ssessed were quite similar across the nursing assessment forms. The time to complete the form varied from less than I minute to 80 minutes. For those scales with reported diagnostic accuracy, sensitivity varied from 43% to 10 0% (median = 80%), and specificity varied from 38% to 96% (median = 75%). S everal scales with superior diagnostic characteristics were identified. Conclusions. A substantial number of fall risk assessment tools are readily available and assess similar patient characteristics. Although their diagn ostic accuracy and overall usefulness showed wide variability, there are se veral scales that can be used with confidence as part of an effective falls prevention program. Consequently, there should be little need for faciliti es to develop their own scales. To continue to develop fall risk assessment s unique to individual facilities may be counterproductive because scores w ill not be comparable across facilities.