PURPOSE
This study was designed to develop, to implement and evaluate a fever management nursing protocol for adult patients.
METHODS
This study was conducted through seven steps following both the guideline development procedures of the Scottish Intercollegiate Guidelines Network and the Model of the Asan Medical Center Evidence-Based Practice, as follows: 1) identifying the clinical needs and composition of the protocol development group; 2) identifying and evaluating the evidence; 3) assessing the level of evidence and grading recommendations; 4) forming a protocol; 5) evaluating the protocol using an expert group validity test and identifying barriers to its implementation; 6) protocol development; and 7) evaluation of practical improvement measures following implementation of the protocol.
RESULTS
The evidence-based protocol for fever management in adult patients was completed and includes five domains and 15 items. The protocol had good content validity (CVI=.90) and nursing practice could be improved after implementation of the protocol.
CONCLUSION
This nursing protocol can be used as a guide for nursing in febrile adult patients. We recommend that further guidelines be updated in an interdisciplinary manner in order to foster local adaptation of the best clinical practices.

Citations

• Comparison of Clinical Outcomes between Rebound Hyperthermia and Non-Rebound Hypertherma Groups in Postcardiac Arrest Syndrome Patients Undergoing Targeted Temperature Management
  Ha Na Rhee, Jeong Yun Park
  Journal of Korean Critical Care Nursing.2023; 16(3): 99.     CrossRef
• Development and Effectiveness of Practice Application Program of Intravenous Infusion Evidence-Based Nursing Practice Guideline - for Small and Medium Sized Hospitals
  Inhwa Hong, Young Eun
  Journal of Korean Academy of Nursing.2020; 50(6): 863.     CrossRef
• Performance and Influencing Factors of Evidence‐Based Pressure Ulcer Care Among Acute Care Hospital Nurses
  Ji‐Kyo Kim, Sung‐Hee Yoo, Ju‐Hee Nho, Jae‐Kyun Ju
  Worldviews on Evidence-Based Nursing.2019; 16(1): 29.     CrossRef
• Critical Review I to Standardize the Textbooks of Fundamentals of Nursing: Vital Sign Assessment, Body Temperature Regulation, Oxygenation
  YunHee Shin, Seung Kyo Chaung, Hyun-Ju Kim
  Journal of Korean Academy of Fundamentals of Nursing.2019; 26(4): 282.     CrossRef
• Tepid massage for febrile children: A systematic review and meta‐analysis
  Junghee Lim, Juyoung Kim, Bora Moon, Gaeun Kim
  International Journal of Nursing Practice.2018;[Epub]     CrossRef
• Schools’ Response to MERS(MERS-CoV) Outbreak: Schools’ Discretionary Response in Absence of Control Tower
  In Sook Lee, Jae Hee Yoon, Eun Joo Hong, Chae Yoon Kim
  Journal of the Korean Society of School Health.2015; 28(3): 188.     CrossRef

PURPOSE
The aim of the study was to identify the most appropriate fall-risk assessment tool for neurological patients in an acute care setting.
METHODS
This descriptive study compared the reliability and validity of three fall-risk assessment tools (Morse Fall Scale, MFS; St Thomas's Risk Assessment Tool in Falling Elderly Inpatients, STRATIFY; Hendrich II Fall Risk Model, HFRM II). We assessed patients who were admitted to the Department of Neurology, Neurosurgery, and Rehabilitation at Asan Medical Center between July 1 and October 31, 2011, using a constructive questionnaire including general and clinical characteristics, and each item from the three tools. We analyzed inter-rater reliability with the kappa value, and the sensitivity, specificity, predictive value, and the area under the curve (AUC) of the three tools.
RESULTS
The analysis included 1,026 patients, and 32 falls occurred during this study. Inter-rater reliability was above 80% in all three tools. and the sensitivity was 50.0% (MFS), 84.4%(STRATIFY), and 59.4%(HFRM II). The AUC of the STRATIFY was 82.8. However, when the cutoff point was regulated as not 50 but 40 points, the AUC of the MFS was higher at 83.7.
CONCLUSION
These results suggest that the STRATIFY may be the best tool for predicting falls for acute neurological patients.

Citations

• Effects of Forest Environment on Peak Cough Flow and Dyspnea in Patients with Neurological Disorders
  Jung Woo Shin, Jong Hwan Choi
  Journal of People, Plants, and Environment.2025; 28(2): 209.     CrossRef
• Changes in Health Risks, Daily Activities and Antipsychotic Use After Humanitude Care for People With Dementia: A Retrospective Study
  Sungjun Kim, Jiyoung Kim, SungWoo Chung, Ju Young Sim
  Journal of Clinical Nursing.2025;[Epub]     CrossRef
• Sensitivity of Fall Risk Perception and Associated Factors in Hospitalized Patients with Mental Disorders
  Ji Young Kim, Sung Reul Kim, Yusun Park, Jin Kyeong Ko, Eunmi Ra
  Asian Nursing Research.2024; 18(5): 443.     CrossRef
• Congruency and its related factors between patients' fall risk perception and nurses' fall risk assessment in acute care hospitals
  Jieun Choi, Sujin Lee, Eunjin Park, Sangha Ku, Sunhwa Kim, Wonhye Yu, Eunmi Jeong, Sookhee Park, Yusun Park, Sung Reul Kim
  Journal of Nursing Scholarship.2024; 56(4): 507.     CrossRef
• Falls in Patients of Medical Institutions in South Korea: A Literature Review
  Jongwon Choi, Woochol Joseph Choi
  Physical Therapy Korea.2023; 30(1): 1.     CrossRef
• Development and validation of interpretable machine learning models for inpatient fall events and electronic medical record integration
  Soyun Shim, Jae Yong Yu, Seyong Jekal, Yee Jun Song, Ki Tae Moon, Ju Hee Lee, Kyung Mi Yeom, Sook Hyun Park, In Sook Cho, Mi Ra Song, Sejin Heo, Jeong Hee Hong
  Clinical and Experimental Emergency Medicine.2022; 9(4): 345.     CrossRef
• Factors included in adult fall risk assessment tools (FRATs): a systematic review
  Hendrika de Clercq, Alida Naudé, Juan Bornman
  Ageing and Society.2021; 41(11): 2558.     CrossRef
• Factors Influencing Falls in High- and Low-Risk Patients in a Tertiary Hospital in Korea
  Young-Shin Lee, Eun-Ju Choi, Yeon-Hee Kim, Hyeoun-Ae Park
  Journal of Patient Safety.2020; 16(4): e376.     CrossRef
• Predictors of Health-related Quality of Life among Spouses of Older Adults with Dementia in the Community-dwelling
  Hye-Young Jang, Song Yi Han
  Journal of Korean Academy of Community Health Nursing.2019; 30(4): 518.     CrossRef
• Effects of Fall Prevention Education Program on Attitudes, Prevention Behaviors, and Satisfaction among Elderly Inpatients
  Young Ok Kang, Rhayun Song
  Korean Journal of Adult Nursing.2018; 30(1): 49.     CrossRef
• Risk factors of falling in patients with neurological diseases
  Michaela Miertová, Ivana Bóriková, Martina Tomagová, Katarína Žiaková
  Kontakt.2018; 20(3): e217.     CrossRef
• Characteristics and Risk Factors for Falls in Tertiary Hospital Inpatients
  Eun-Ju Choi, Young-Shin Lee, Eun-Jung Yang, Ji-Hui Kim, Yeon-Hee Kim, Hyeoun-Ae Park
  Journal of Korean Academy of Nursing.2017; 47(3): 420.     CrossRef
• A prediction model of falls for patients with neurological disorder in acute care hospital
  Sung-Hee Yoo, Sung Reul Kim, Yong Soon Shin
  Journal of the Neurological Sciences.2015; 356(1-2): 113.     CrossRef
• Validation of Fall Risk Assessment Scales among Hospitalized Patients in South Korea using Retrospective Data Analysis
  Young Ok Kang, Rhayun Song
  Korean Journal of Adult Nursing.2015; 27(1): 29.     CrossRef
• Evaluation of Clinical Usefulness of Delirium Assessment Tools for Elderly Patients after Neurosurgery
  Su-Jung Kim, Jun-Ah Song
  Journal of Korean Gerontological Nursing.2015; 17(1): 38.     CrossRef