Predicting Falls in Nursing Homes: A Prospective Multicenter Cohort Study Comparing Fall History, Staff Clinical Judgment, the Care Home Falls Screen, and the Fall Risk Classification Algorithm

Objectives To evaluate and compare the predictive accuracy of fall history, staff clinical judgment, Care Home Falls Screen (CaHFRiS), Fall Risk Classification Algorithm (FRiCA). Design Prospective multicenter cohort study with 6 months' follow-up. Setting Participants A total 420 residents from 15 nursing homes participated. Methods judgment (ie, physiotherapists, nurses nurses' aides), CaHFRiS FRiCA were assessed at baseline, falls documented in follow-up period. Predictive was calculated 1, 3, months by means sensitivity, specificity, positive negative value, likelihood ratio, Youden Index, overall accuracy. Results In total, 658 occurred 50.2% had least 1 an average rate 1.57 (SD 2.78, range 0-20) per resident. The for all screening methods measuring points ranged 54.8% to 66.5%. FRiCA, a score ?4 better ranging 64.4% 80.8%, compared disciplines (sensitivity 47.4% 71.2%). value (ranging 92.9% month 59.6% months) higher scores ?4. Specificity 50.3% 77.5% months, specificity physiotherapists worse FRiCA. Positive 22.2% (clinical aides) 67.8% physiotherapists). Conclusions Implications No strong recommendations can be made use any method. More research on identifying highest risk is crucial, as these benefit most multifactorial assessments subsequent tailored interventions.