DOI QR코드

DOI QR Code

Validation of Adult Fall Assessment Scale Korean Version for Adult Patients in General Hospitals in Korea

한국형 낙상 위험 사정도구의 타당성 평가연구

  • Choi, Eun Hee (Department of Nursing, Korean Bible University) ;
  • Ko, Mi Suk (Department of Nursing, Korean Bible University) ;
  • Lee, Shin Ae (Department of Nursing, Seoul ST. Mary's Hospital) ;
  • Park, Jung Ha (Department of Nursing, Hanyang University Medical Center)
  • Received : 2020.05.31
  • Accepted : 2020.06.23
  • Published : 2020.08.31

Abstract

Purpose: The purpose of this study was to test the predictive validity of the Fall Assessment Scale-Korean version (FAS-K) and to find the most appropriate cutoff score to screen high-risk fall groups in adult patients in general hospitals in Korea. Methods: We performed a prospective evaluation study in medical and surgical ward patients at two major general hospitals in Seoul. Data were collected from Nov. 1, 2018 to Feb. 28, 2019, nurses performed 651 observation series. The researcher measured the fall risk assessment score by applying FAS-K, MFS (Morse Fall Scale), and JHFRAT (Johns Hopkins Hospital Fall Risk Assessment tool) to the patients twice a week between 10 am and 12 noon. Data were analyzed using Pearson's corelation coefficients, and the sensitivity, specificity, predictive value, and the area under the curve (AUC) of the three tools. Results: The FAS-K was positively correlated with the MFS (r=.70, p<.001) and the JHFRAT (r=.82, p<.001). According to the receiver operating characteristics (ROC) curve analysis of the FAS-K, sensitivity, specificity, and positive and negative prediction values were 85.3%, 49.4%, 8.5%, and 98.4%, respectively, when the FAS-K score was 4. Therefore, the cut-off score of the FAS-K to identify groups with high fall risk was 4. Conclusion: The FAS-K is a valid tool for measuring fall risk in adult inpatients. In addition, the FAS-K score, 4, can be used to identify high-risk fall groups and know specific points in time to provide active interventions to prevent falls.

Keywords

References

  1. Ministry of Health and Welfare, Korea Institute for Healthcare Accreditation. Korea patient safety incident report 2018 [Internet]. Seoul: Korea Institute for Healthcare Accreditation; 2019. [cited 2020 May 28]. Available from: https://www.kops.or.kr/portal/board/reference/boardDetail.do?bbsId=reference&nttNo=11544070324902.
  2. Morello RT, Barker AL, Watts JJ, Haines T, Zavarsek SS, Hill KD, et al. The extra resource burden of in-hospital falls: A cost of falls study. Medical Journal of Australia. 2015;203(9):367-367. https://doi.org/10.5694/mja15.00296
  3. Cho IS, Park KH, Suh MH, Kim EM. Evidence-based clinical nursing practice guideline for management of inpatient falls: Adopting the guideline adaptation process. Journal of Korean Academy of Fundamentals of Nursing. 2020;27(1):40-51. https://doi.org/10.7739/jkafn.2020.27.1.40
  4. Lee JH, Kim HA, Park SW. Prevention of fall in the hospital. Journal of the Korean Medical Association. 2015;58(2):123-130. https://doi.org/10.5124/jkma.2015.58.2.123
  5. Choi EH, Ko MS, Yoo CS, Kim MK. Characteristics of fall events and fall risk factors among inpatients in general hospitals in Korea. Journal of Korean Clinical Nursing Research. 2017;23(3):350-360. https://doi.org/10.22650/JKCNR.2017.23.3.350
  6. Morse JM. Enhancing the safety of hospitalization by reducing patient falls. American Journal of Infection Control. 2002;30(6):376-380. https://doi.org/10.1067/mic.2002.125808
  7. Chun JH, Kim HA, Kwak MJ, Kim HS, Park SK, Kim MS, et al. Clinical practice guideline for assessment and prevention of falls in adult people. Quality Improvement in Health Care. 2018;24(2):41-61. https://doi.org/10.14371/QIH.2018.24.2.41
  8. Cho YS, Lee YO, Youn YS. Risk factors for falls in tertiary hospital inpatients: A survival analysis. Journal of Korean Critical Care Nursing. 2019;12(1):57-70. https://doi.org/10.34250/jkccn.2019.12.1.57
  9. Baek S, Piao J, Jin Y, Lee SM. Validity of the Morse Fall Scale implemented in an electronic medical record system. Journal of Clinical Nursing. 2014;23(17-18):2434-2441. https://doi.org/10.1111/jocn.12359
  10. Haines TP, Hill K, Walsh W, Osborne R. Design-related bias in hospital fall risk screening tool predictive accuracy evaluations: Systematic review and meta-analysis, Journals of Gerontology: Series A, Biological Sciences and Medical Sciences. 2007;62(6):664-672. https://doi.org/10.1093/gerona/62.6.664
  11. Perell KL, Nelson A, Goldman RL, Luther SL, Prieto-Lewis N, Rubenstein LZ. Fall risk assessment measures: An analytic review. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2001;56(12):M761-M766. https://doi.org/10.1093/gerona/56.12.M761
  12. Kim KS, Kim JA, Choi YK, Kim YJ, Park MH, Kim HY, et al. A comparative study on the validity of fall risk assessment scales in Korean hospitals. Asian Nursing Research. 2011;5(1):28-37. https://doi.org/10.1016/S1976-1317(11)60011-X
  13. Kang YO, Song RY. Validation of fall risk assessment scales among hospitalized patients in South Korea using retrospective data analysis. Korean Journal of Adult Nursing. 2015;27(1):29-38. https://doi.org/10.7475/kjan.2015.27.1.29
  14. Park IS, Cho IS, Kim EM, Kim MK. Evaluation of a fall risk assessment tool to establish continuous quality improvement process for inpatients falls. Journal of Korean Academy of Nursing Administration. 2011;17(4):484-492. https://doi.org/10.11111/jkana.2011.17.4.484
  15. Park SH, Kim EK. Systematic review and meta-analysis for usefulness of fall risk assessment tools in adult inpatients. Korean Journal of Health Promotion, 2016;16(3):180-191. https://doi.org/10.15384/kjhp.2016.16.3.180.
  16. Choi EH, Ko MS, Hong SH, Kim IS. Development of fall assessment scale in adult inpatients. Journal of Korean Clinical Nursing Research. 2019;25(2):179-188. https://doi.org/10.22650/JKCNR.2019.25.2.179
  17. Morse JM, Morse RM, Tylko SJ. Development of a scale to identify the fall-prone patient. Canadian Journal on Aging. 1989;8(4):366-377. https://doi.org/10.1017/S0714980800008576
  18. Poe SS, Cvach M, Dawson PB, Straus H, Hill EE. The Johns Hopkins Fall Risk Assessment Tool: Postimplementation evaluation. Journal of Nursing Care Quality. 2007;22(4):293-298. https://doi.org/10.1097/01.NCQ.0000290408.74027.39
  19. Pak SI, Oh TH. Application of Receiver Operating Characteristic(ROC) curve for evaluation of diagnostic test performance. Journal of Veterinary Clinics. 2016;33(2):97-101. https://doi.org/10.17555/jvc.2016.04.33.2.97
  20. Simundic AM. Diagnostic accuracy-part 1: Basic concepts sensitivity and specificity, ROC analysis, STARD statement. Point of Care. 2012;11(1):6-8. https://doi.org/10.1097/POC.0b013e318246a5d6
  21. Kim YS, Choi-Kwon S. Fall risk factors and fall risk assessment of inpatients. Korean Journal of Adult Nursing. 2013;25(1):74-82. https://doi.org/10.7475/kjan.2013.25.1.74
  22. Jang IS, Lee SG. Fall risk factors and characteristics of an acute hospital setting across clinical departments. Journal of Korean Academy of Fundamentals of Nursing. 2014;21(3):264-274. https://doi.org/10.7739/jkafn.2014.21.3.264
  23. Fischer ID, Krauss MJ, Dunagan WC, Birge S, Hitcho E, Johnson S, et al. Patterns and predictors of inpatient falls and fall-related injuries in a large academic hospital. Infection Control & Hospital Epidemiology. 2005;26(10):822-827. https://doi.org/10.1086/502500
  24. Kim JH, Shin SH, Kang HC. A case study on the use of ROC curve and AUC in the evaluation of discriminant model. Journal of the Korean Data Analysis Society. 2018;20(2):609-619. https://doi.org/10.37727/jkdas.2018.20.2.609
  25. Watson BJ, Salmoni AW, Zecevic AA. The use of the Morse Fall Scale in an acute care hospital. Clinical Nursing Studies. 2016;4(2):32-40. https://doi.org/10.5430/cns.v4n2p32
  26. Nam, AR, Park, JW. Development of Korean Intensive Care Delirium Screening Tool(KICDST). Journal of Korean Academy of Nursing. 2016;46(1):149-158. https://doi.org/10.4040/jkan.2016.46.1.149