Fall Risk Assessment in Acute Rehabilitation: Comparison of Two Assessment Tools

Abstract Purpose Many fall risk assessment tools exist. However, few of these fall risk assessment tools have been tested in the acute rehabilitation setting. The purpose of our study was to compare the accuracy of the Hendrich II Fall Risk Model (HIIFRM) and Sunnyview Test Scale in predicting falls. We also identified factors associated with falls in the rehabilitation patient. Design and Methods In this retrospective cohort study, we extracted electronic health record data from two acute inpatient rehabilitation units and compared the predictive validity of the HIIFRM and the Sunnyview Test Scale. Results Our sample included 134 fallers and 1,667 nonfallers. The HIIFRM and the Sunnyview Test Scale had similar predictive performance with area under the receiver operating characteristic curve (AUC) of .62 and .60, respectively. Conclusion The HIIFRM and the Sunnyview Test Scale had poor performance (AUC < .70) predicting falls in this acute rehabilitation setting. Using a fall risk assessment tool alone does not consider unique risk factors and makes implementation of individualized prevention interventions challenging. Nurses need a framework to use individualized factors to determine high fall risk. Further research is needed to clarify variables specific to the inpatient rehabilitation population. Clinical Relevance Current fall risk assessment tools are inadequate in the inpatient rehabilitation setting; an individualized fall prevention plan is recommended to ensure patient safety.