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박인숙 ( Park Ihn-Sook ) - 서울대학교병원 간호부
조인숙 ( Cho In-Sook ) - 인하대학교 의과대학 간호학과
김은만 ( Kim Eun-Man ) - 선문대학교 간호학과
김민경 ( Kim Min-Kyung ) - 인하대학교 의과대학 간호학과
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Abstract
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Purpose: The aims of study were; (1) to evaluate the validity and sensitivity of a fall-risk assessment tool, and (2) to establish continuous quality improvement (CQI) methods to monitor the effective use of the risk assessment tool.
Methods: A retrospective case-control cohort design was used. Analysis was conducted for 90 admissions as cases and 3,716 as controls during the 2006 and 2007 calendar years was conducted. Fallers were identified from the hospital’s Accident Reporting System, and non-fallers were selected by randomized selection. Accuracy estimates, sensitivity analysis and logistic regression were used.
Results: At the lower cutoff score of one, sensitivity, specificity, and positive and negative predictive values were 82.2%, 19.3%, 0.03%, and 96.9%, respectively. The area under the ROC was 0.60 implying poor prediction. Logistic regression analysis showed that five out of nine constitutional items; age, history of falls, gait problems, and confusion were significantly associated with falls. Based on these results, we suggested a tailored falls CQI process with specific indexes.
Conclusion: The fall-risk assessment tool was found to need considerable reviews for its validity and usage problems in practice. It is also necessary to develop protocols for use and identify strategies that reflect changes in patient conditions during hospital stay.
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KeyWords
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낙상, 위험사정 도구, 검사 예측력, 질 관리
Risk assessment, Predictive value of tests, Validation studies, Accidental falls, Hospitalization
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원문 및 링크아웃 정보
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등재저널 정보
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