J Healthc Qual. 2020 Jul/Aug;42(4):205-214. doi: 10.1097/JHQ.0000000000000233.
A hospital's emergency department (ED) used the Johns Hopkins fall risk assessment tool (JHFRAT), which was not developed to assess the ED patients. The ED committee recommended the memorial ED fall risk assessment tool (MEDFRAT) plus a "nursing judgment" category. However, the modified MEDFRAT needed to be evaluated before implementation. This research evaluated the modified MEDFRAT in ED patients and nurses' perception of the tool.
A two-stage quantitative design was used. Stage 1 was a chart review using both tools for patients who fell (n = 57) in the past 4 years and the control patients (n = 57). Two tools were compared using t-tests, Bland-Altman, predictive abilities, and mismatch rates. Stage 2 was the assessment of all ED patients (n = 435) seen by the ED triage nurses for 1 week using both tools. The chi-squared test and mismatch rates were used to compare the tools. Time to complete both tools and nurses' perceptions to the modified MEDFRAT were analyzed.
Two tools were significantly different. The modified MEDFRAT had higher predictive ability and lower mismatch rates than the JHFRAT. It needed shorter time to complete and was preferred by most nurses.
The modified MEDFRAT is adequate to use in the ED.
医院的急诊部门（ED）使用了约翰霍普金斯跌倒风险评估工具（JHFRAT），该工具并非专为评估 ED 患者而开发。ED 委员会建议使用纪念 ED 跌倒风险评估工具（MEDFRAT）加“护理判断”类别。然而，在实施之前，需要对修改后的 MEDFRAT 进行评估。这项研究评估了 ED 患者和护士对该工具的修改后的 MEDFRAT 的看法。
采用两阶段定量设计。第 1 阶段是对过去 4 年中跌倒的患者（n = 57）和对照组患者（n = 57）使用两种工具进行图表回顾。使用 t 检验、Bland-Altman、预测能力和不匹配率比较两种工具。第 2 阶段是在 ED 分诊护士对 1 周内看到的所有 ED 患者（n = 435）使用两种工具进行评估。使用卡方检验和不匹配率比较工具。分析完成两种工具所需的时间以及护士对修改后的 MEDFRAT 的看法。
两种工具存在显著差异。修改后的 MEDFRAT 具有更高的预测能力和更低的不匹配率，比 JHFRAT 完成时间更短，且更受大多数护士的青睐。
修改后的 MEDFRAT 可在 ED 中使用。
