{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T09:02:36Z","timestamp":1771232556497,"version":"3.50.1"},"reference-count":53,"publisher":"Wiley","issue":"5-6","license":[{"start":{"date-parts":[[2018,1,15]],"date-time":"2018-01-15T00:00:00Z","timestamp":1515974400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec><jats:title>Aims and objectives<\/jats:title><jats:p>To develop a falls risk screening tool (FRST) sensitive to the traumatic brain injury rehabilitation population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Falls are the most frequently recorded patient safety incident within the hospital context. The inpatient traumatic brain injury rehabilitation population is one particular population that has been identified as at high risk of falls. However, no FRST has been developed for this patient population. Consequently in the traumatic brain injury rehabilitation population, there is the real possibility that nurses are using falls risk screening tools that have a poor clinical utility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Multisite prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Univariate and multiple logistic regression modelling techniques (backward elimination, elastic net and hierarchical) were used to examine each variable's association with patients who fell. The resulting FRST's clinical validity was examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 140 patients in the study, 41 (29%) fell. Through multiple logistic regression modelling, 11 variables were identified as predictors for falls. Using hierarchical logistic regression, five of these were identified for inclusion in the resulting falls risk screening tool: prescribed mobility aid (such as, wheelchair or frame), a fall since admission to hospital, impulsive behaviour, impaired orientation and bladder and\/or bowel incontinence. The resulting FRST has good clinical validity (sensitivity\u00a0=\u00a00.9; specificity\u00a0=\u00a00.62; area under the curve\u00a0=\u00a00.87; Youden index\u00a0=\u00a00.54). The tool was significantly more accurate (<jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>.037 on DeLong test) in discriminating fallers from nonfallers than the Ontario Modified <jats:styled-content style=\"fixed-case\">STRATIFY<\/jats:styled-content> FRST.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A FRST has been developed using a comprehensive statistical framework, and evidence has been provided of this tool's clinical validity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to clinical practice<\/jats:title><jats:p>The developed tool, the Sydney Falls Risk Screening Tool, should be considered for use in brain injury rehabilitation populations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocn.14048","type":"journal-article","created":{"date-parts":[[2017,8,23]],"date-time":"2017-08-23T02:32:43Z","timestamp":1503455563000},"page":"958-968","source":"Crossref","is-referenced-by-count":7,"title":["Development of the Sydney Falls Risk Screening Tool in brain injury rehabilitation: A multisite prospective cohort study"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2880-5276","authenticated-orcid":false,"given":"Duncan","family":"McKechnie","sequence":"first","affiliation":[{"name":"Sydney Nursing School The University of Sydney Brain Injury Unit Royal Rehab Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murray J","family":"Fisher","sequence":"additional","affiliation":[{"name":"Sydney Nursing School The University of Sydney Nursing Research &amp; Development Royal Rehab Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Pryor","sequence":"additional","affiliation":[{"name":"Sydney Nursing School The University of Sydney Nursing Research &amp; Development Royal Rehab Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Bonser","sequence":"additional","affiliation":[{"name":"Liverpool Hospital Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jhoven De","family":"Jesus","sequence":"additional","affiliation":[{"name":"Westmead Brain Injury Rehabilitation Service Westmead Hospital Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,1,15]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7118.1309"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.12651"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2004.04.003"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1198\/0003130043277"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2010.05503.x"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/qshc.2007.025676"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-9-64"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2011.07.031"},{"key":"e_1_2_12_10_1","first-page":"26","article-title":"Changing the approach to falls in TBI","volume":"2","author":"Carmine H.","year":"2005","journal-title":"Brain Injury Professional"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.6432"},{"key":"e_1_2_12_12_1","unstructured":"Clinical Excellence Commission(2013)Clinical focus report \u2013 Falls.Sydney NSW Australia:Clinical Excellence Commission. Retrieved fromhttp:\/\/www.cec.health.nsw.gov.au\/publications"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-172x.2001.00269.x"},{"key":"e_1_2_12_14_1","volume-title":"Discovering statistics using IBM SPSS statistics","author":"Field A.","year":"2013"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/RNJ.00010"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00024665-200605000-00014"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.2048-7940.1987.tb00560.x"},{"key":"e_1_2_12_18_1","first-page":"627","article-title":"Receiver operating characteristic (ROC) curve analysis for medical diagnostic test evaluation","volume":"4","author":"Hajian\u2010Tilaki K.","year":"2013","journal-title":"Caspian Journal of Internal Medicine"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(01)00406-1"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19960229)15:4<361::AID-SIM168>3.0.CO;2-4"},{"key":"e_1_2_12_21_1","unstructured":"Healey F. &Scobie S. (2007).The third report from the patient safety observatory. Slips trips and falls in hospital. The National Patient Safety Agency (NPSA). Retrieved fromhttp:\/\/www.nrls.npsa.nhs.uk\/resources\/collections\/pso-reports\/?entryid45=59"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1053\/apnr.2003.016009"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/0962280214541852"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajag.12256"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2013.04.001"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.12542"},{"key":"e_1_2_12_27_1","unstructured":"McFadden D. (1997).Quantitative Methods for Analyzing Travel Behaviour of Individuals: Some Recent Developments. Cowles Foundation Discussion Paper number 474 Connecticut USA:Yale University."},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0000000000000146"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.13087"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2014.1002578"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.12977"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2016.1212112"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(02)00453-5"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-015-0066-2"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-172X.2003.00430.x"},{"key":"e_1_2_12_36_1","unstructured":"NSW Agency for Clinical Innovation Brain Injury Rehabilitation Directorate(2015).NSW Brain Injury Rehabilitation Program 2011 and 2012 Annual Report.Sydney NSW Australia:NSW Agency for Clinical Innovation Retrieved fromhttp:\/\/www.aci.health.nsw.gov.au\/networks\/brain-injury-rehabilitation"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.28.4.716"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7115.1049"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afh017"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afn203"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-2-1"},{"key":"e_1_2_12_42_1","first-page":"1","article-title":"How to develop a more accurate risk prediction model when there are few events","volume":"351","author":"Pavlou M.","year":"2015","journal-title":"BMJ"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.NCQ.0000290408.74027.39"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.10.974"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-9993(93)90160-C"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/rnj.114"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/NCQ.0000000000000158"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.2340\/16501977-0550"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1741-6612.2009.00375.x"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(01)00341-9"},{"key":"e_1_2_12_51_1","unstructured":"Tate R. L. Cameron I. Winstanley J. Myles B. &Harris R. (2004).Brain Injury Outcome Study: Final Report Rehabilitation Studies Unit Northern Clinical School.Australia:Faculty of Medicine The University of Sydney"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1002\/rnj.211"},{"key":"e_1_2_12_53_1","unstructured":"World Health Organisation(2007).WHO Global Report on Falls Prevention in Older Age.Geneva Switzerland:World Health OrganizationRetrieved fromhttp:\/\/www.who.int\/violence_injury_prevention\/publications\/other_injury\/falls_prevention.pdf?ua=1"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001786-200504000-00007"}],"container-title":["Journal of Clinical Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjocn.14048","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocn.14048","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T11:29:39Z","timestamp":1694690979000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocn.14048"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,15]]},"references-count":53,"journal-issue":{"issue":"5-6","published-print":{"date-parts":[[2018,3]]}},"alternative-id":["10.1111\/jocn.14048"],"URL":"https:\/\/doi.org\/10.1111\/jocn.14048","archive":["Portico"],"relation":{},"ISSN":["0962-1067","1365-2702"],"issn-type":[{"value":"0962-1067","type":"print"},{"value":"1365-2702","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,15]]}}}