임상간호연구 (Journal of Korean Clinical Nursing Research)

  • 제28권3호
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  • Pages.270-276
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  • 2022
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  • 1598-9186(pISSN)
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  • 2287-3694(eISSN)
병원간호사회 (Hospital Nurses Association)
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정신건강의학과 입원 환자를 위한 낙상 위험 사정도구 (Edmonson Psychiatric Fall Risk Assessment Tool)의 타당도 평가: 후향적 연구

Validation of the Edmonson Psychiatric Fall Risk Assessment Tool for Psychiatric Inpatients: A Retrospective Study

  • Kim, Kyung Young (Department of Nursing, Samsung Medical Center) ;
  • Son, Young Sun (Department of Nursing, Samsung Medical Center) ;
  • Lee, You Ji (Department of Nursing, Samsung Medical Center) ;
  • Kim, Ji Eun (Department of Nursing, Samsung Medical Center) ;
  • Kim, Mi Kyung (Department of Nursing, Samsung Medical Center) ;
  • YI, Young Hee (Graduate School of Clinical Nursing Science, Sungkyungkwan University)
  • 투고 : 2022.09.30
  • 심사 : 2022.10.24
  • 발행 : 2022.12.31
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초록

Purpose: The purpose of this study was to validate the Edmonson psychiatric fall risk assessment tool (EPFRAT) for psychiatric inpatients. Methods: Data from retrospective study were collected from 670 adult inpatients in two departments of mental health medicine of a tertiary general hospital by reviewing their electronic medical records. There were 41 patients who experienced falls and 629 patients who did not experience falls during the period from January to December 2019. Data were analyzed by sensitivity, specificity, positive predictive value, negative predictive value, and a receiver-operating characteristic curve (ROC) for validity assessment using the IBM SPSS/WIN 26.0 program. Results: Factors affecting falls were the participant's age, guardian's residence, high-risk determination at the time of admission, and comorbidity. At the 85 points where the point of sum of the sensitivity and specificity was largest, the sensitivity, specificity, positive predictive value, and negative predictive value of EPFRAT were 92.7%, 79.7%, 22.9%, and 99.4%, respectively. The area under the ROC to assess the overall validity of the tool was .92 (95% CI 0.89~0.94). Conclusion: The EPFRAT was proved to be valid and reasonable for predicting falls in psychiatric inpatients. Based on the results of this study, it could be used for the assessment of high-risk patients for falls in psychiatric units.

키워드

과제정보

본 연구는 2020년 삼성서울병원 간호본부에서 연구비를 지원받아 진행한 연구임.

참고문헌

  1. 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
  2. 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
  3. Korea Institute for Healthcare Accreditation. Standard guidelines for evaluation of psychiatric institutions in four cycles. Ministry of Health and Welfare; 2020. p. 32-33.
  4. Bugajski A, Lengerich A, McCowan D, Merritt S, Moe K, Hall B, et al. The Baptist health high-risk falls assessment: One assessment fits all. Journal of Nursing Care Quality. 2017;32 (2):114-119. https://doi.org/10.1097/ncq.0000000000000220
  5. Turner K, Bjarnadottir R, Jo A, Repique RJ, Thomas J, Green J, et al. Patient falls and injuries in U.S. psychiatric care: Incidence and trends. Psychiatric Services. 2020;71(9):899-905. https://doi.org/10.1176/appi.ps.202000004
  6. Kim SK, Lee SH, Lee SH, Song JJ, Gwak MJ, Lee HS, et al. Analysis of fall accidents of dizzy patients in a tertiary hospital in South Korea (2011-2015). Korean Journal of Otorhinolaryngology-Head Neck Surgery. 2017;60(6):271-278. https://doi.org/10.3342/kjorl-hns.2016.17531
  7. Edmonson D, Robinson S, Hughes L. Development of the Edmonson psychiatric fall risk assessment tool. Journal of Psychosocial Nursing and Mental Health Services. 2011;49(2):29-36. https://doi.org/10.3928/02793695-20101202-03
  8. Park KM. A study on sedation, delirium and fall in mental illness taking psychiatric drugs. Journal of Industrial Convergence. 2020;18(4):33-40. https://doi.org/10.22678/JIC.2020.18.4.033
  9. Rutledge DN, Donaldson NE, Pravikoff DS. Fall risk assessment and prevention in hospitalized patients. Online Journal of Clinical Innovation. 2003;6:1-55.
  10. Abraham S. Looking for a psychiatric fall risk assessment tool. Annals Psychiatry and Mental Health. 2016;4(2):1061.
  11. Mathew L, Steigman D, Driscoll D, Moran-Peters JA, Fischer IM, Cordle P, et al. Making fall risk assessment clinically relevant in an adult psychiatric setting. Journal of Psychosocial Nursing and Mental Health Services. 2020;58(2):21-26. https://doi.org/10.3928/02793695-20191106-01
  12. 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
  13. 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
  14. 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
  15. 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 and Hospital Epidemiology. 2005;26(10):822-827. https://doi.org/10.1086/502500
  16. 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
  17. Choi EJ, Lee YS, Yang EJ, Kim JH, Kim YH, Park HA. Characteristics and risk factors for falls in tertiary hospital inpatients. Journal of Korean Academy Nursing. 2017;47(3): 420-430. https://doi.org/10.4040/jkan.2017.47.3.420
  18. Tsai YF, Witte N, Radunzel M, Keller ML. Falls in a psychiatric unit. Applied Nursing Research. 1998;11(3):115-121. https://doi.org/10.1016/S0897-1897(98)80112-2
  19. Ebesutani C, Drescher CF, Reise SP, Heiden L, Hight TL, Damon JD, et al. The loneliness questionnaire-short version: An evaluation of reverse-worded and non-reverse-worded items via item response theory. Journal of Personality Assessment. 2012;94(4):427-437. https://doi.org/10.1080/00223891.2012.662188
  20. Guyatt G, Walter S, Norman G. Measuring change over time: Assessing the usefulness of evaluative instruments. Journal of Chronic Disease. 1987;40(2):171-178. https://doi.org/10.1016/0021-9681(87)90069-5
  21. Schwendimann R, De Greet S, Milisen K. Evaluation of the Morse fall scale in hospitalized patients. Age and Ageing. 2006;35(3):311-313. https://doi.org/10.1093/ageing/afj066