Are your patients safe to mobilize alone in their room? The Johns Hopkins Hospital In-Room Independence Scale (JH-IRIS)

Abstract

Abstract Objective Given the stigma of falls while hospitalized, inpatient rehabilitation facilities (IRF) often restrict the independent room mobility of their patients. We assessed the psychometric properties of a new tool, the Johns Hopkins In-Room Independence Scale (JH-IRIS), to evaluate its effectiveness at identifying independence for in-room mobility. Design Construct validity was assessed by comparing the JH-IRIS to its “gold standard” counterparts, The Johns Hopkins Falls Risk Assessment Tool (JHFRAT), the Activity Measure for Post-Acute Care (AM-PAC) Mobility and Activity, and the Centers for Medicare Quality Indicators (QI). Reliability was assessed via Cronbach’s Alpha. Results 197 episodes were included. Construct validity: JH-IRIS had significantly negative low correlation to the JHFRAT (Spearman’s Rho –0.281), and a significant moderate correlation to the AM-PAC Activity and AM-PAC Mobility (Spearman’s Rho, 0.678 and 0.530, respectively). The JH-IRIS was moderately positively correlated to the QIs for mobility and activity (Spearman’s Rho 0.577 and 0.643, respectively). All two tailed, alpha level 0.01. JH-IRIS' reliability was strong (Cronbach’s Alpha 0.822, 15 items). Sensitivity and specificity were both 100%. Conclusion Given the moderate validity, strong reliability, and high sensitivity/specificity, our study suggests the JH-IRIS can be used to identify patients who have the capacity to mobilize independently in their room.