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Original Article

Validation of Fall Risk Assessment Scales among Hospitalized Patients in South Korea using Retrospective Data Analysis

Young Ok Kang, Rhayun Song
Korean J Adult Nurs 2015;27(1):29-38. Published online: February 28, 2015
1Chungnam National University Hospital, Daejeon, Korea.
2College of Nursing, Chungnam National University, Daejeon, Korea. songry@cnu.ac.kr
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Abstract

PURPOSE
The purpose of the study was to validate fall risk assessment scales among hospitalized adult patients in South Korea using the electronic medical records by comparing sensitivity, specificity, positive predictive values, and negative predictive values of Morse Fall Scale (MFS), Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS), and Johns Hopkins Hospital Fall Risk Assessment tool (JHFRAT).
METHODS
A total of 120 patients who experienced fall episodes during their hospitalization from June 2010 to December 2013 was categorized into the fall group. Another 120 patients, who didn't experience fall episodes with age, sex, clinical departments, and the type of wards matched with the fall group, were categorized to the comparison group. Data were analyzed for the comparisons of sensitivity, specificity, positive and negative predictive values, and the area under the curve of the three tools.
RESULTS
MFS at a cut-off score of 48 had .806 for ROC curves, 76.7% for sensitivity, 77.5% for specificity, 77.3% for positive predictive value, and 76.9% for negative predictive value, which were the highest values among the three fall assessment scales.
CONCLUSION
The MFS with the highest score and the highest discrimination was evaluated to be suitable and reasonable for predicting falls of inpatients in med-surg units of university hospitals.


Korean J Adult Nurs. 2015 Feb;27(1):29-38. Korean.
Published online Feb 28, 2015.
https://doi.org/10.7475/kjan.2015.27.1.29
© 2015 Korean Society of Adult Nursing
Original Article

Validation of Fall Risk Assessment Scales among Hospitalized Patients in South Korea using Retrospective Data Analysis

Young Ok Kang,1 and Rhayun Song2
    • 1Chungnam National University Hospital, Daejeon, Korea.
    • 2College of Nursing, Chungnam National University, Daejeon, Korea.
  • Corresponding author: Song, Rhayun. College of Nursing, Chungnam National University, 266 Munhwa-ro, Jung-gu, Daejeon 301-747, Korea. Tel: +82-42-580-8331, Fax: +82-42-580-8309, Email: songry@cnu.ac.kr
Received October 21, 2014; Revised February 10, 2015; Accepted February 11, 2015.

Abstract

Purpose

The purpose of the study was to validate fall risk assessment scales among hospitalized adult patients in South Korea using the electronic medical records by comparing sensitivity, specificity, positive predictive values, and negative predictive values of Morse Fall Scale (MFS), Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS), and Johns Hopkins Hospital Fall Risk Assessment tool (JHFRAT).

Methods

A total of 120 patients who experienced fall episodes during their hospitalization from June 2010 to December 2013 was categorized into the fall group. Another 120 patients, who didn't experience fall episodes with age, sex, clinical departments, and the type of wards matched with the fall group, were categorized to the comparison group. Data were analyzed for the comparisons of sensitivity, specificity, positive and negative predictive values, and the area under the curve of the three tools.

Results

MFS at a cut-off score of 48 had .806 for ROC curves, 76.7% for sensitivity, 77.5% for specificity, 77.3% for positive predictive value, and 76.9% for negative predictive value, which were the highest values among the three fall assessment scales.

Conclusion

The MFS with the highest score and the highest discrimination was evaluated to be suitable and reasonable for predicting falls of inpatients in med-surg units of university hospitals.

Keywords
Inpatients; Accidental falls; Risk assessment; Validity

Figures

Figure 1
Receiver operating characteristics curves of the three fall risk assessment scales.

Figure 2
Receiver operating characteristics curves of the three fall risk assessment scales for participants from the medical or surgical units.

Tables

Table 1
Comparison of General Characteristics and Homogeneity Tests between the Fall and Non-fall Groups (N=240)

Table 2
Mean Scores of Fall Risk Assessment Scales by Department (N=240)

Table 3
Sensitivity, Specificity, PPV and NPV by Scales at each Cut-off Score by Department

Notes

This manuscript is a condensed form of the first author's doctoral dissertation from Chungnam National University.

References

    1. Korea Institute for Healthcare Accreditation. Accreditation Standards 2.0. Department of Health and Human Services; 2014. pp. 19-20.
    1. Bouldin ED, Andresen EM, Dunton NE, Simon M, Waters TM, Liu M, et al. Falls among adult patients hospitalized in the United States: prevalence and trends. Journal of Patient Safety 2013;9(1):13–17. [doi: 10.1097/PTS.0b013e3182699b64]
    1. Oliver D, Healey F, Haines TP. Preventing falls and fall-related injuries in hospitals. Clinics in Geriatric Medicine 2010;26(4):645–692. [doi: 10.1016/j.cger.2010.06.005]
    1. Kim YS, Choi-Kwon SM. Fall risk factors and fall risk assessment of inpatients. Korean Journal of Adult Nursing 2013;25(1):74–82. [doi: 10.7475/kjan.2013.25.1.74]
    1. Kim CG. In: An analysis of fall incidence rate and its related factors of fall in inpatients. [master's thesis]. Seoul: Seoul National University; 2002.
    1. Coussement J, De Paepe L, Schwendimann R, Denhaerynck K, Dejaeger E, Milisen K. Interventions for preventing falls in acute-and chronic-care hospitals: a systematic review and meta-analysis. Journal of the American Geriatrics Society 2008;56(1):29–36. [doi: 10.1111/j.1532-5415.2007.01508.x]
    1. Bergland A, Wyller TB. Risk factors for serious fall related injury in elderly women living at home. Injury Prevention 2004;10(5):308–313. [doi: 10.1136/ip.2003.004721]
    1. Oliver D, Daly F, Martin FC, McMurdo MET. Risk factors and risk assessment tools for falls in hospital in-patients: a systematic review. Age and Ageing 2004;33(2):122–130. [doi: 10.1093/ageing/afh017]
    1. Lopez KD, Gerling GJ, Cary MP, Kanak MF. Cognitive work analysis to evaluate the problem of patient falls in an inpatient setting. Journal of the American Medical Informatics Association 2010;17(3):313–321. [doi: 10.1136/jamia.2009.000422]
    1. Morse JM. In: Preventing patient falls: establishing a fall intervention program. New York: Springer; 2009.
    1. Morse JM. Enhancing the safety of hospitalization by reducing patient falls. American Journal of Infection Control 2002;30(6):376–380. [doi: 10.1067/mic.2002.125808]
    1. Kim SR, Yoo SH, Shin YS, Jeon JY, Kim JY, Kang SJ, et al. Comparison of the reliability and validity of fall risk assessment tools in patients with acute neurological disorders. Korean Journal of Adult Nursing 2013;25(1):24–32. [doi: 10.7475/kjan.2013.25.1.24]
    1. Kim KS, Kim JA, Kim MS, Kim YJ, Kim ES, Park KO, et al. Development of performance measures based on the nursing process for prevention and management of pressure ulcers, falls and pain. Journal of Korean Clinical Nursing Research 2009;15(1):133–147.
    1. Myers H, Nikoletti S. Fall risk assessment: a prospective investigation of nurses’ clinical judgement and risk assessment tools in predicting patient falls. International Journal of Nursing Practice 2003;9(3):158–165. [doi: 10.1046/j.1440-172X.2003.00409.x]
    1. Chapman J, Bachand D, Hyrkas K. Testing the sensitivity, specificity and feasibility of four falls risk assessment tools in a clinical setting. Journal of Nursing Management 2011;19(1):133–142. [doi: 10.1111/j.1365-2834.2010.01218.x]
    1. Kim EA, Mordiffi SZ, Bee WH, Devi K, Evans D. Evaluation of three fall-risk assessment tools in an acute care setting. Journal of Advanced Nursing 2007;60(4):427–435. [doi: 10.1111/j.1365-2648.2007.04419.x]
    1. O'Connell B, Myers H. The sensitivity and specificity of the morse fall scale in an acute care setting. Journal of Clinical Nursing 2002;11(1):134–136. [doi: 10.1046/j.1365-2702.2002.00578.x]
    1. 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. [doi: 10.1016/S1976-1317(11)60011-X]
    1. Beack YG. Fall risk of patients admitted to emergency room. Global Health Nursing 2011;2(1):34–42.
    1. 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. [doi: 10.11111/jkana.2011.17.4.484]
    1. Baek SY. In: Clinical usability evaluation of fall risk assessment tool implemented in the electronic medical record system. [master's thesis]. Seoul: Catholic University; 2012.
    1. Vassallo M, Stockdale R, Sharma JC, Briggs R, Allen S. A comparative study of the use of four fall risk assessment tools on acute medical wards. Journal of the American Geriatrics Society 2005;53(6):1034–1038. [doi: 10.1111/j.1532-5415.2005.53316.x]
    1. Perell KL, Nelson A, Goldman RL, Luther SL, Prieto-Lewis N, Rubenstein LZ. Fall risk assessment measures: an analytic review. The journals of gerontology. Series A, Biological sciences and medical sciences 2001;56(12):M761–M766. [doi: 10.1093/gerona/56.12.M761]
    1. Morse J, Morse R, Tylko S. Development of a scale to identify the fall-prone patient. Canadian Journal on Aging 1989;8(4):366–377. [doi: 10.1017/S0714980800008576]
    1. Poe SS, Cvach M, Gartrell GD, Radzik RB, Joy LT. An Evidence-based approach to fall risk assessment, prevention, and management lesson learned. Journal of Nursing Care Quality 2005;20(2):107–116.
    1. Korea National Statistical Office. Statistical report on the aged. [Internet]. Seoul: Statistics Korea; 2011 [cited 2014 July 30].
      Available from: http://kostat.go.kr/portal/korea/.
    1. Schwendimann R, De Geest S, Milisen K. Evaluation of the morse fall scale in hospitalized patients. Age and Ageing 2006;35(3):311–313. [doi: 10.1093/ageing/afj066]
    1. Lee YH, Jung IS, Jun SS. A comparative study on the predictive validity among pressure ulcer risk assessment scales. Journal of Korean Academy of Nursing 2003;33(2):162–169.

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Validation of Fall Risk Assessment Scales among Hospitalized Patients in South Korea using Retrospective Data Analysis
Korean J Adult Nurs. 2015;27(1):29-38.   Published online February 28, 2015
DOI: https://doi.org/10.7475/kjan.2015.27.1.29
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Validation of Fall Risk Assessment Scales among Hospitalized Patients in South Korea using Retrospective Data Analysis
Korean J Adult Nurs. 2015;27(1):29-38.   Published online February 28, 2015
DOI: https://doi.org/10.7475/kjan.2015.27.1.29
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