PMID- 36716642
OWN - NLM
STAT- MEDLINE
DCOM- 20230310
LR  - 20230322
IS  - 1525-5069 (Electronic)
IS  - 1525-5050 (Linking)
VI  - 140
DP  - 2023 Mar
TI  - Retrospective analysis of nurse-administered fall assessment scales in the 
      Epilepsy Monitoring Unit.
PG  - 109080
LID - S1525-5050(22)00529-7 [pii]
LID - 10.1016/j.yebeh.2022.109080 [doi]
AB  - INTRODUCTION: Inpatient falls within the Epilepsy Monitoring Unit (EMU) are a 
      common, and potentially preventable adverse event contributing to morbidity for 
      patients living with epilepsy. Accurate fall risk screening is important to 
      identify and efficiently allocate proper safety measures to high-risk patients, 
      especially in EMUs with limited resources. We sought to compare existing 
      screening tools for the ability to predict falls in the EMU. METHODS: This is a 
      retrospective, single-center, case-controlled, comparative analysis of 7 
      nurse-administered fall risk assessment tools (NAFRAT) of patients admitted to 
      the Vanderbilt University Medical Center (VUMC) EMU. Analysis of categorical data 
      was compared using chi-square analysis while quantitative distributions were 
      compared using student's t-test. RESULTS: A total of 56 patient records (28 falls 
      and 28 controls) were included in the analysis. Epilepsy Monitoring Unit falls 
      were most common within the first 3 days of admission (p = .0094). Pre-admission 
      documentation of falls was a strong predictor of falls within the EMU 
      (p < .0001). Epilepsy Monitoring Unit falls were associated with documented falls 
      after EMU discharge (p = .011). The John Hopkins fall risk assessment tool 
      (JHFRAT) accurately stratified fall risk in the fall group compared to the 
      control (p = .008), however, none of the 7 NAFRATs demonstrated significant 
      categorical differences among the epilepsy subgroups. There was a significant 
      difference in the distribution of quantitative scores, higher in the fall group 
      according to the Morse Fall Scale (MFS) (p = 0.012), JHFRAT (p = 0.003), Schmid 
      Fall Risk Assessment Scale (p = 0.029) and Hester-Davis Scale (p = 0.049). The 
      modified Conley (p = 0.03) and Morse scale (p = 0.025) demonstrated differences 
      in the distribution of quantitative scores in the epilepsy subgroups. CONCLUSION: 
      The findings of this study demonstrate variable accuracy of NAFRATs in assessing 
      fall risk among patients admitted to the EMU, particularly among patients with 
      epilepsy. The findings underscore the need for a validated, EMU-specific, fall 
      assessment tool that accurately stratifies fall risk and inform efficient use of 
      patient-specific fall prevention resources and protocols.
CI  - Copyright (c) 2022 Elsevier Inc. All rights reserved.
FAU - Johnson, Michael A L
AU  - Johnson MAL
AD  - Vanderbilt University Medical Center, Department of Neurology, United States. 
      Electronic address: Michaelaljohnson85@gmail.com.
FAU - Boudreaux, Arlene
AU  - Boudreaux A
AD  - Vanderbilt Heart and Vascular Institute, Department of Clinical Administration, 
      United States.
FAU - Abou-Khalil, Bassel
AU  - Abou-Khalil B
AD  - Vanderbilt University Medical Center, Department of Neurology, United States.
LA  - eng
PT  - Journal Article
DEP - 20230128
PL  - United States
TA  - Epilepsy Behav
JT  - Epilepsy & behavior : E&B
JID - 100892858
SB  - IM
MH  - Humans
MH  - Retrospective Studies
MH  - *Epilepsy/diagnosis
MH  - Risk Assessment
MH  - Hospitalization
MH  - Inpatients
OTO - NOTNLM
OT  - Epilepsy Monitoring Unit (EMU)
OT  - Fall-risk
OT  - Falls
OT  - National Database of Nursing Quality Indicators (NDNQI)
OT  - Nurse-Administered Fall Risk Assessment Tools (NAFRAT)
OT  - Safety
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2023/01/31 06:00
MHDA- 2023/03/11 06:00
CRDT- 2023/01/30 18:12
PHST- 2022/08/08 00:00 [received]
PHST- 2022/12/27 00:00 [revised]
PHST- 2022/12/29 00:00 [accepted]
PHST- 2023/01/31 06:00 [pubmed]
PHST- 2023/03/11 06:00 [medline]
PHST- 2023/01/30 18:12 [entrez]
AID - S1525-5050(22)00529-7 [pii]
AID - 10.1016/j.yebeh.2022.109080 [doi]
PST - ppublish
SO  - Epilepsy Behav. 2023 Mar;140:109080. doi: 10.1016/j.yebeh.2022.109080. Epub 2023 
      Jan 28.