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Agreement of fall classifications among staff in U.S. hospitals

Agreement of fall classifications among staff in U.S. hospitals
Agreement of fall classifications among staff in U.S. hospitals
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.
0029-6562
Simon, Michael
6e9ad30e-c22f-455a-945e-98d77dcec479
Klaus, Susan
8ab4fe2c-008f-4f62-8894-e77fe54b4771
Gajewski, Byron
f0e40bd2-b276-470b-8789-f86baa5ff7aa
Dunton, Nancy
5165aeec-97a5-4bb8-9f67-f46f3aaf4a3b
Simon, Michael
6e9ad30e-c22f-455a-945e-98d77dcec479
Klaus, Susan
8ab4fe2c-008f-4f62-8894-e77fe54b4771
Gajewski, Byron
f0e40bd2-b276-470b-8789-f86baa5ff7aa
Dunton, Nancy
5165aeec-97a5-4bb8-9f67-f46f3aaf4a3b

Simon, Michael, Klaus, Susan, Gajewski, Byron and Dunton, Nancy (2013) Agreement of fall classifications among staff in U.S. hospitals. Nursing Research. (doi:10.1097/NNR.0b013e31827bf8c9). (PMID:23302822)

Record type: Article

Abstract

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.

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23302822_cmd=HTOn& - Accepted Manuscript
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23302822_cmd=ClearHT& - Accepted Manuscript
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23302822_cmd=HTOff& - Accepted Manuscript
Restricted to Repository staff only
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23302822 - Accepted Manuscript
Restricted to Repository staff only

More information

e-pub ahead of print date: 8 January 2013
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 346922
URI: http://eprints.soton.ac.uk/id/eprint/346922
ISSN: 0029-6562
PURE UUID: 15ca3213-2a8d-480b-a5b2-d92aa8bce380

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Date deposited: 24 Jan 2013 12:02
Last modified: 14 Mar 2024 12:43

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Contributors

Author: Michael Simon
Author: Susan Klaus
Author: Byron Gajewski
Author: Nancy Dunton

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