Date of Award
Dr. Cynthia D. Connelly, PhD, RN, FAAN, Chairperson; Jane M. Georges, PhD, RN; Ruth A. Bush, PhD, MPH, FAMIA
Fall Risk, Perception, Falls, Elderly Falls
Purpose: The purpose of the study was to describe the relationship between patient
perception of fall risk and high fall risk screening scores.
Background: Despite mandated government regulations and multiple hospital
interventions, falls are the most prevalent adverse event among hospitalized patients and
are the leading driver of health care costs, amounting to over $30 billion each year with
projections to double by 2030. Recently, perception was identified as a major component
in preventing falls. A dearth of research examines the relationship between a patient’s
perceived risk for falls and standardized fall screening scores.
Methods: A descriptive correlational design with a convenience sample of 201 inpatient
adults aged 65 and older screened as a high fall risk > 11 Johns Hopkins fall risk score
(JHFRS) was enrolled from medical surgical units in a Magnet®-designated Southern
California hospital from July to September 2018. After providing informed consent,
participants completed 4 perception measures. Bivariate analyses examined relationships
between select variables and JHFRS group (≥16). Logistic regression model examined
odds ratios of 5 variables from the bivariate analysis.
Results: The sample (n=201) was diverse (61.7% Caucasian, 16.4% Black, 15.9%
Hispanic, 2.5% Asian, 3.5% Other), 91.5% English speaking and 8.5% Spanish speaking.
Mean age 77.1 ± 7.9 (range 65-99). Confidence was the only perception scale
significantly associated with fall risk (r= -0.194, p=.01). Bivariate analysis indicated
significant relationships between 75th percentile high fall risk (JHFRS ≥16) and Central
Nervous System (CNS) agents (χ2=5.45, p=.02), Caucasian versus non-Caucasian group
(χ2=4.71, p=.03), less than college versus some college or more group (χ2=4.664, p=.03),
and number of co-morbidities (χ2=2.120, p=.04). Education was significantly associated
with race (χ2=14.121), p<.001).
Implications: Study findings indicate patient perception of confidence is associated with
75th percentile of high fall risk (score ≥16). Further research is warranted to examine
perceptions related to fall risk screening in other settings and factors related to perception
to accurately identify patients at risk for falling. Screening and accurately identifying
patients at risk for falls can lead to decreased morbidity, mortality, health care cost, and
improved patient outcomes.
Dissertation: Open Access
Digital USD Citation
Pena, Nicole D., "Patient Perception of Fall Risk and High Fall Risk Screening Scores" (2019). Dissertations. 133.