Date of Award


Degree Name

PhD Nursing

Dissertation Committee

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.

Document Type

Dissertation: Open Access