Diagnostic Validity of the Care Dependency Scale as a Screening Tool for Pressure Ulcer and Fall Risks in Dutch and German Hospitals

Elke Mertens*, Theo Dassen, Ramona Scheufele, Ruud J. Halfens, Antje Tannen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Pressure ulcers and falls are frequent adverse events with negative impacts for hospital patients. Guidelines recommend risk assessment as the first step in prevention. Care dependency correlates with falls and pressure ulcers and the Care Dependency Scale showed a diagnostic validity comparable to that of specific risk assessment tools. The aim of this study was to establish a simple and valid screening index for the risk of falls and pressure ulcers in hospitals by using the Care Dependency Scale and to evaluate this index within two validation samples from different countries. Quantitative, cross-sectional data from two German surveys and one Dutch survey were analysed. A total of 305 Dutch and German hospitals with 21,880 patients took part. The diagnostic validity of the Care Dependency Scale was evaluated by computing receiver operator characteristics curves, the areas under the curves, sensitivity, specificity and positive and negative predictive values. The Scale demonstrated a good diagnostic validity for pressure ulcer risk screening in Dutch and German hospitals. The diagnostic validity regarding the risk for falls was satisfying in Germany and moderate in the Netherlands. Using the Care Dependency Scale for risk screening could reduce the necessity of further assessment by more than a half.
Original languageEnglish
Pages (from-to)577-587
JournalCentral European Journal of Medicine
Issue number5
Publication statusPublished - Oct 2010


  • Accidental Falls
  • Hospitals
  • Nursing Home
  • Pressure Ulcer
  • Risk Assessment

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