Document Detail


Agreement of fall classifications among staff in U.S. hospitals.
MedLine Citation:
PMID:  23302822     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patient falls in hospitals are a performance measure endorsed by the National Quality Forum. Agreement of staff classifications of fall situations is not documented.
OBJECTIVES: The aims of this study were to (a) investigate how experts classify fall scenarios according to the fall definition of the National Quality Forum; (b) investigate how nursing staff classifies the same fall scenarios; and (c) assess the extent to which fall classifications differ among units, hospitals, and individuals.
METHODS: Twenty video scenarios of falls were embedded in an online video survey. A panel of 24 experts and 6,342 hospital staff members from 362 units in 170 U.S. hospitals were asked to classify fall and nonfall scenarios. Experts consisted of nurses, physicians, physical therapists, and statisticians. Hospital staff were registered nurses (78%), unlicensed staff (15%), and other staff (7%).
RESULTS: Experts unambiguously classified 14 out of 20 scenarios according to the National Quality Forum fall definition, whereas hospital staff clearly classified 12 scenarios. Experts and hospital staff did not agree on 4 out of 20 scenarios. The sensitivity was 0.90, the specificity was 0.88, and the mean probability for classifying a scenario as a fall was 0.60.
DISCUSSION: Results indicate that the National Quality Forum fall definition needs further refinement to classify all scenarios properly. Although variability between individuals indicates some potential for fall reporting training, variability between units and hospitals does not seem to affect fall reporting.
Authors:
Michael Simon; Susan Klaus; Byron J Gajewski; Nancy Dunton
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Nursing research     Volume:  62     ISSN:  1538-9847     ISO Abbreviation:  Nurs Res     Publication Date:    2013 Mar-Apr
Date Detail:
Created Date:  2013-03-05     Completed Date:  2013-04-15     Revised Date:  2013-05-02    
Medline Journal Info:
Nlm Unique ID:  0376404     Medline TA:  Nurs Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  74-81     Citation Subset:  AIM; IM; N    
Affiliation:
Centre for Innovation and Leadership in Health Sciences, Faculty of Health Sciences, University of Southampton, UK. m.simon@soton.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Accidental Falls / statistics & numerical data*
Adult
Female
Hospital Units / statistics & numerical data
Hospitals / statistics & numerical data
Humans
Male
Medical Staff, Hospital* / statistics & numerical data
Middle Aged
Nursing Evaluation Research
Nursing Staff, Hospital* / statistics & numerical data
Observer Variation*
Quality Indicators, Health Care
Reproducibility of Results
Terminology as Topic
United States
Videotape Recording

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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