Development and Validation of a Fall Risk Assessment Scale for Hospitalized Children in Korea
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Purpose: This study aims to develop a pediatric fall risk assessment scale and examine its validity and reliability. Methods: The study was conducted in two phases. First, we developed a preliminary fall risk assessment scale based on a literature review and an evaluation by 10 expert panels. Second, we tested the validity and reliability of the scale through in a retrospective case-control study. The dataset included 102 reported falls and 306 non-falls in one hospital over approximately 9 years (2005~2014). We performed a conditional logistic regression analysis to determine significance and predictability and a receiver operating characteristic (ROC) curve analysis to test the validity of the scale’s final version. Results: The pediatric fall risk assessment scale included five factors: age, level of consciousness, gait ability, medication, and use of equipment. The area under the curve of the ROC was .75 (95% Confidence Interval [CI]: .70~.80; p<.001) at the time of hospital admission and .76 (95% CI: .70~81; p<.001) within 24 hours of a fall. The scale had high inter-rater reliability, with kappa values ranging from 0.89 to 1.00. Conclusion: We developed a fall risk assessment scale with high reliability and validity through a systematic process by accurately predicting the risk of falls among pediatric inpatients to reduce fall incidence rates.
Abstract
Purpose: This study aims to develop a pediatric fall risk assessment scale and examine its validity and reliability. Methods: The study was conducted in two phases. First, we developed a preliminary fall risk assessment scale based on a literature review and an evaluation by 10 expert panels. Second, we tested the validity and reliability of the scale through in a retrospective case-control study. The dataset included 102 reported falls and 306 non-falls in one hospital over approximately 9 years (2005~2014). We performed a conditional logistic regression analysis to determine significance and predictability and a receiver operating characteristic (ROC) curve analysis to test the validity of the scale’s final version. Results: The pediatric fall risk assessment scale included five factors: age, level of consciousness, gait ability, medication, and use of equipment. The area under the curve of the ROC was .75 (95% Confidence Interval [CI]: .70~.80; p<.001) at the time of hospital admission and .76 (95% CI: .70~81; p<.001) within 24 hours of a fall. The scale had high inter-rater reliability, with kappa values ranging from 0.89 to 1.00. Conclusion: We developed a fall risk assessment scale with high reliability and validity through a systematic process by accurately predicting the risk of falls among pediatric inpatients to reduce fall incidence rates.
참고문헌 (36)
- Linda S. Franck, "The Little Schmidy Pediatric Hospital Fall Risk Assessment Index: A diagnostic accuracy study", International Journal of Nursing Studies, 68, pp.51~59 (2017), Elsevier BV[DOI]
- Kimberly DiGerolamo, "An Integrative Review of Pediatric Fall Risk Assessment Tools", Journal of Pediatric Nursing, 34, pp.23~28 (2017), Elsevier BV[DOI]
- 박소연, "아동낙상예방교육이 입원아동 보호자의 낙상관련 지식과 예방행위에 미치는 효과", 한국간호교육학회지, 23(4), pp.398~408 (2017), 한국간호교육학회[DOI]
- 진미숙, "상급종합병원과 종합병원 간호사의 낙상예방활동 영향 요인", 보건정보통계학회지, 42(4), pp.361~370 (2017), 한국보건정보통계학회[DOI]
- 최은주, "일개 종합병원 입원환자의 낙상관련 특성 및 낙상발생 예측요인", Journal of Korean Academy of Nursing, 47(3), pp.420~430 (2017), 한국간호과학회
- Christopher R. Carpenter, "Risk Factors and Screening Instruments to Predict Adverse Outcomes for Undifferentiated Older Emergency Department Patients: A Systematic Review and Meta‐analysis", Academic Emergency Medicine, 22(1), pp.1~21 (2015), Wiley[DOI]
- Eun-Joo Kim, "A Systematic Review and Meta-Analysis of Fall Prevention Programs for Pediatric Inpatients", International Journal of Environmental Research and Public Health, 18(11), pp.5853~ (2021), MDPI AG[DOI]
- Christopher P. Landrigan, "Performance of the Global Assessment of Pediatric Patient Safety (GAPPS) Tool", Pediatrics, 137(6) (2016), American Academy of Pediatrics (AAP)[DOI]
- Rees P, "Patient safety incidents involving sick children in primary care in England and Wales : a mixed methods analysis", PLoS Medicine, 14(1), pp.e1002217~ (2017)
- Jamerson PA, "Inpatient falls in freestanding children's hospitals", Pediatric Nursing, 40(3), pp.127~ (2014)
- Deborah Hill‐Rodriguez, "The Humpty Dumpty Falls Scale: A Case–Control Study", Journal for Specialists in Pediatric Nursing, 14(1), pp.22~32 (2009), Wiley[DOI]
- Elaine Graf, "Magnet Children's Hospitals: Leading Knowledge Development and Quality Standards for Inpatient Pediatric Fall Prevention Programs", Journal of Pediatric Nursing, 26(2), pp.122~127 (2011), Elsevier BV[DOI]
- Razmus I, "Falls in hospitalized children", Pediatric Nursing, 32(6), pp.568~ (2006)
- Banan Abdullah AlSowailmi, "Prevalence of fall injuries and risk factors for fall among hospitalized children in a specialized children’s hospital in Saudi Arabia", Annals of Saudi Medicine, 38(3), pp.225~229 (2018), King Faisal Specialist Hospital and Research Centre[DOI]
- 김금순, "A Comparative Study on the Validity of Fall Risk Assessment Scales in Korean Hospitals", Asian Nursing Research, 5(1), pp.28~37 (2011), 한국간호과학회
- Graf E, "The epidemiology of falls in hospitalized children", Pediatric Nursing, 38(4), pp.236~ (2012)
- Angalakuditi MV, "Causes and consequences of injuries in children in Western Australia", Risk Management and Healthcare Policy, 4, pp.107~111 (2011)
- Jenae Neiman, "Development, implementation, and evaluation of a comprehensive fall risk program", Journal for Specialists in Pediatric Nursing, 16(2), pp.130~139 (2011), Wiley[DOI]
- Ciofi D, "Prevalence and multicenter observational study on falls of hospitalized children and Italian, linguistic-cultural validation of the Humpty Dumpty Fall Scale", Professioni Infermieristiche, 73(4), pp.296~304 (2020)[DOI]
- 김은주, "Meta-analysis of the Diagnostic Test Accuracy of Pediatric Inpatient Fall Risk Assessment Scales", Child Health Nursing Research, 25(1), pp.56~64 (2019), 한국아동간호학회[DOI]
- Heidi L. McNeely, "Pediatric Fall Risk Assessment Tool Comparison and Validation Study", Journal of Pediatric Nursing, 41, pp.96~103 (2018), Elsevier BV[DOI]
- Ryan-Wenger NA, "Challenges and conundrums in the validation of pediatric fall risk assessment tools", Pediatric Nursing, 38(3), pp.159~167 (2012)
- Lynn MR, "Determination and quantification of content validity", Nursing Research, 35(6), pp.382~386 (1986)
- Denise F. Polit, "The content validity index: Are you sure you know what's being reported? critique and recommendations", Research in Nursing & Health, 29(5), pp.489~497 (2006), Wiley[DOI]
- Wacholder S, "Selection of controls in case-control studies : III. Design options", American Journal of Epidemiology, 135(9), pp.1042~1050 (1992)
- Ariel Linden, "Measuring diagnostic and predictive accuracy in disease management: an introduction to receiver operating characteristic (ROC) analysis", Journal of Evaluation in Clinical Practice, 12(2), pp.132~139 (2006), Wiley[DOI]
- 조명숙, "아동 입원환자의 낙상위험 예측요인", Journal of Korean Academy of Nursing, 43(5), pp.595~604 (2013), 한국간호과학회
- Caitlin Parker, "Analysis of Falls within Paediatric Hospital and Community Healthcare Settings", Journal of Pediatric Nursing, 50, pp.31~36 (2020), Elsevier BV[DOI]
- Moretta P, "Family caregivers' opinions about interaction with the environment in consciousness disorders", Rehabilitation Psychology, 62(2), pp.208~213 (2017)[DOI]
- Sofia Chaudhary, "Pediatric falls ages 0–4: understanding demographics, mechanisms, and injury severities", Injury Epidemiology, 5(S1), pp.77~87 (2018), Springer Science and Business Media LLC[DOI]
- Ching-Mei Chang, "Reliability and Validity of a Pediatric Fall Risk Assessment Scale for Hospitalized Patients in Taiwan", Quality Management in Health Care, 30(2), pp.121~126 (2020), Ovid Technologies (Wolters Kluwer Health)[DOI]
- Graf E, "Magnet children's hospitals : leading knowledge development and quality standards for inpatient pediatric fall prevention programs", Journal of Pediatric Nursing, 26(2), pp.122~127 (2011)[DOI]
- Suzanne Ekelund, "ROC Curves—What are They and How are They Used?", Point of Care: The Journal of Near-Patient Testing & Technology, 11(1), pp.16~21 (2012), Ovid Technologies (Wolters Kluwer Health)[DOI]
- Jackie Gonzalez, "Evaluating the Humpty Dumpty Fall Scale", Journal of Nursing Care Quality, 35(4), pp.301~308 (2020), Ovid Technologies (Wolters Kluwer Health)[DOI]
- Sackinger D, "GRAF-PIF fall risk assessment tool : predictive accuracy in a children's hospital", Pediatric Nursing, 47(4), pp.180~197 (2021)
- Habip Almis, "Risk Factors Related to Caregivers in Hospitalized Children's Falls", Journal of Pediatric Nursing, 32, pp.3~7 (2017), Elsevier BV[DOI]