Date of Award

Spring 2-20-2018

Degree Type

Dissertation

Degree Name

PhD Health Sciences

Department

Health and Medical Sciences

Advisor

Genevieve Pinto Zipp, Ed.D.

Committee Member

Deborah DeLuca, J.D.

Committee Member

Ning Zhang, Ph.D.

Keywords

falls, hospital, geriatric psychiatry, patient mobility, fall risk assessment, Timed Up and Go Test

Abstract

Background: Patient falls during hospitalization influence healthcare costs and quality, and hospitals are mandated to complete fall risk assessments on all patients. Inpatient geriatric psychiatry units have the highest fall rates in the acute care setting, and most falls in this population occur during the mobility tasks of transfers and ambulation. The Timed Up and Go (TUG) test includes these two specific functional tasks, and has been used to predict falls in other geriatric populations, but has never been tested in an inpatient geriatric psychiatry unit. The purpose of this study was to determine if the TUG is a predictive tool to identify high fall risk patients in the inpatient geriatric psychiatry setting. Methods: The study was a retrospective chart review using a between groups design. The sample was obtained from patients admitted to one inpatient geriatric psychiatry unit during the four month study period. Results: The total sample size was N = 62 and included 33 non-fallers and 29 fallers. The mean age of fallers (M = 75.79, SD = 9.60) was not significantly different from the age of non-fallers (M = 74.03, SD = 7.62), p = .424. Both groups had higher proportions of female subjects; non-faller 75.8% (n = 25) female and faller 69.0% (n = 20) female. Most non-fallers (84.8%) completed the TUG testing without an assistive device, while most fallers (48.3%) used a walker. A significant difference was found between the TUG times of non-fallers and fallers, U = 737.00, z = 3.65, p = <.001, r = .46. Fallers took longer to complete the TUG test (Mdn = 26.48) than non-fallers (Mdn = 13.56). The TUG time predictor variable was statistically significant, p = .002. Increasing TUG times were associated with an increased likelihood of patient falls (OR = 1.10). The optimal TUG cut-off score was 16.46 seconds, with 79.3% sensitivity and 72.7% specificity. Conclusions: The TUG was found to be a predictive tool to identify high fall risk patients in the inpatient geriatric psychiatry setting. A cut-off time of 16.46 seconds is recommended to identify non-fallers from fallers in this patient population.

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