Review of Fall Risk Assessment Scales

Pad pacijenta u bolničkoj ustanovi spada u neželjene događaje u zdravstvenoj ustanovi te je jedan od pokazatelja sigurnosti pacijenta i indikator kvalitete u sustavu akreditacije. Otprilike trećina padova uzrokuje neki oblik ozljede pacijenta te direktno pridonosi smanjenju kvalitete zdravstvene skrbi uz različite psihofizičke poteškoće. Stoga je nužnost prevencije pada pacijenata važna dužnost svih zdravstvenih djelatnika, a posebno medicinskih sestara i tehničara. Jedan od alata za pomoć pri procjeni rizika od pada jesu standardizirane skale koje se primjenjuju u tu svrhu. U ovom radu prikazane su četiri različite ljestvice: Morseova skala, skala STRATIFY, skala Hendrich II. te skala koju je osmislilo osoblje baltimorske bolnice Johns Hopkins. Svaka od njih ima određene prednosti i nedostatke, a poželjno je da im je osjetljivost i specifičnost što veća. Idealna skala trebala bi biti jednostavna za upotrebu, precizna, ne iziskivati previše vremena za ispunjavanje te biti lako uklopiva u kliničku praksu bez dodatnog opterećivanja. Rezultat skale jest numerička vrijednost kojom se kod pacijenta procjenjuje rizik od pada (nizak, srednji, visok...) te se u skladu s time provode odgovarajuće preventivne mjere.Patient falls in a hospital setting are adverse events in health care institution and pose as one of indicators of patient safety and quality indicators when it comes to the accreditation system. About one third of all falls cause some form of injury to the patient, and directly contribute to the lower healthcare quality level, inducing thereby also a variety of mental and somatic symptoms experienced by the patient. Therefore, the necessity of preventing patient falls is an important duty of all healthcare professionals, especially nurses. One of the tools for assessing the risk of falls risk is a standardized fall risk assessment scale. This paper presents four such scales, as follows: the Morse Falls Scale, the STRATIFY Scale, the Hendrich II Scale and the Johns Hopkins Fall Risk Assessment Tool. Each of them has certain advantages and disadvantages, all of them preferably having as high sensitivity and specificity as possible. An ideal scale should be simple to use, accurate, not time-consuming and easily implementable into clinical practice without staff overload. A result provided by a scale is a numerical value, which assesses patients’ risk of falling (low, medium, high ...); such a risk assessment should always be followed by the appropriate preventive measures