Adding value to the STRATIFY falls risk assessment in acute hospitals
Adding value to the STRATIFY falls risk assessment in acute hospitals
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DOI：
10.1111/j.1365-2648.2010.05503.x
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发表时间：
2011-02-01
影响因子：
3.8
通讯作者：
Hill, Keith
中科院分区：
文献类型：
--
作者：
Barker, Anna;Kamar, Jeannette;Hill, Keith
目的：本文是一份研究报告，旨在比较北方医院改良的圣托马斯风险评估工具和圣托马斯风险评估工具对跌倒者的预测准确性，并确定每种工具的评估者间一致性。背景：福尔斯风险评估是预防跌倒的关键组成部分。一个工具的clinimetric属性的调查应完成之前，它被用于在clinical practice.Methods。本地福尔斯数据被用来通知修改的圣托马斯的风险评估工具，以提高跌倒预测。在急性住院患者的前瞻性横断面研究中，对St托马斯风险评估工具和北方医院改良St托马斯风险评估工具的临床特征进行了检查。第一阶段包括使用敏感性、特异性和约登指数（J）评估263例患者的预测准确性。II期评价涉及使用Kappa统计量（kappa）评估52例患者的评估者间一致性。结果：平衡障碍、年龄80岁及以上、药物和酒精问题被确定为北方医院人群中额外的福尔斯危险因素，并被添加到圣托马斯风险评估工具中。北方医院改良的St托马斯风险评估工具具有更高的灵敏度（0中心点65 vs. 0中心点35，P = 0中心点016）。St托马斯风险评估工具具有更高的特异性（0中心点93 vs. 0中心点79，P = 0中心点000）。北方医院改进的托马斯风险评估工具具有更高的总体准确性（J）（0个中心点44与0个中心点28，P = 0个中心点006）。北方医院修改托马斯的风险评估工具的评分员间协议是公平的（卡帕= 0中心点34）和低的托马斯的风险评估工具（卡帕= 0中心点19）conclusion.The Northern Hospital Modified St托马斯's Risk Assessment Tool and St托马斯's Risk Assessment Tool accurately identified patients at risk of falling.北方医院改良的圣托马斯风险评估工具更准确。不应使用有效性和可靠性未知的工具。未来的研究需要提供证据，证明使用福尔斯风险评估对减少患者福尔斯有积极影响。
P>Aim.This paper is a report of a study conducted to compare the predictive accuracy for fallers of The Northern Hospital Modified St Thomas's Risk Assessment Tool and St Thomas's Risk Assessment Tool, and to determine the inter-rater agreement of each tool.Background.Falls risk assessment is a key component of fall prevention. Investigation of clinimetric properties of a tool should be completed before it are used in clinical practice.Methods.Local falls data were used to inform modification of the St Thomas's Risk Assessment Tool to improve faller prediction. Clinimetric properties of the St Thomas's Risk Assessment Tool and The Northern Hospital Modified St Thomas's Risk Assessment Tool were examined in a prospective cross-sectional study with acute hospital patients. Phase I involved assessment of predictive accuracy using sensitivity, specificity and the Youden Index (J) with 263 patients. Phase II of the evaluation involved assessment of inter-rater agreement using the Kappa statistic (kappa) with 52 patients. Data were collected in 2008.Results.Impaired balance, age 80 years and older and drug and alcohol problems were identified as additional falls risk factors in The Northern Hospital population and added to the St Thomas's Risk Assessment Tool. The Northern Hospital Modified St Thomas's Risk Assessment Tool had higher sensitivity (0 center dot 65 vs. 0 center dot 35, P = 0 center dot 016). The St Thomas's Risk Assessment Tool had higher specificity (0 center dot 93 vs. 0 center dot 79, P = 0 center dot 000). The Northern Hospital Modified St Thomas's Risk Assessment Tool had the greater overall accuracy (J) (0 center dot 44 vs. 0 center dot 28, P = 0 center dot 006). Inter-rater agreement of The Northern Hospital Modified St Thomas's Risk Assessment Tool was fair (kappa = 0 center dot 34) and low for the St Thomas's Risk Assessment Tool (kappa = 0 center dot 19).Conclusion.The Northern Hospital Modified St Thomas's Risk Assessment Tool and St Thomas's Risk Assessment Tool accurately identified patients at risk of falling. The Northern Hospital Modified St Thomas's Risk Assessment Tool was more accurate. Tools which have unknown validity and reliability should not be used. Future research is needed to provide evidence that use of falls risk assessments has a positive impact on reducing patient falls.