Classification of Injurious Fall Severity in Hospitalized Adults
Classification of Injurious Fall Severity in Hospitalized Adults
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DOI：
10.1093/gerona/glaa004
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发表时间：
2020-10-01
影响因子：
5.1
通讯作者：
Dykes, Patricia C.
中科院分区：
文献类型：
--
作者：
Burns, Zoe;Khasnabish, Srijesa;Dykes, Patricia C.
背景资料：美国的许多医院系统使用国家护理质量指标数据库分类报告了伤害性住院福尔斯：无、轻微、中度、严重和死亡。主要类别是不精确的，包括从手腕骨折到潜在致命的硬膜下血肿的伤害。本项目的目的是完善重大伤害分类，以获得一个有效的和可靠的分类的类型和严重程度的重大住院跌倒相关injuries.Methods：基于已发表的文献和排名的伤害性跌倒事件报告（n = 85）从一个大型学术医疗中心，我们分为三个子类的护理质量指标的国家数据库：导致暂时性功能障碍的重大A类损伤（如手腕骨折），面部严重损伤，无内伤（如鼻骨骨折）或手术伤口破裂;导致长期功能障碍或有增加死亡率潜在风险的重大B型损伤（例如，多发性肋骨骨折）;以及具有明确死亡风险的重大C型损伤（例如，髋部骨折）。根据文献和专家意见，我们的研究小组达成共识，在行政手册，以促进准确的分类重大伤害到三个子categorization.Results之一：该团队测试和验证的每一个类别，导致优秀的评分员之间的可靠性（Kappa = 0.96）。重大伤害，主要的A，B和C的分布分别为40.3%，16.1%和43.6%，respectively.Conclusions：这些子类提高了国家数据库的护理质量指标分类。使用管理手册，受过训练的人员可以分类伤害性跌倒的严重程度具有良好的可靠性。
Background: Many hospital systems in the United States report injurious inpatient falls using the National Database of Nursing Quality Indicators categories: None, Minor, Moderate, Major, and Death. The Major category is imprecise, including injuries ranging from a wrist fracture to potentially fatal subdural hematoma. The purpose of this project was to refine the Major injury classification to derive a valid and reliable categorization of the types and severities of Major inpatient fall-related injuries.Methods: Based on published literature and ranking of injurious fall incident reports (n = 85) from a large Academic Medical Center, we divided the National Database of Nursing Quality Indicators Major category into three subcategories: Major A-injuries that caused temporary functional impairment (eg, wrist fracture), major facial injury without internal injury (eg, nasal bone fracture), or disruption of a surgical wound; Major B-injuries that caused long-term functional impairment or had the potential risk of increased mortality (eg, multiple rib fractures); and Major C-injuries that had a well-established risk of mortality (eg, hip fracture). Based on the literature and expert opinion, our research team reached consensus on an administration manual to promote accurate classification of Major injuries into one of the three subcategories.Results: The team tested and validated each of the categories which resulted in excellent interrater reliability (kappa = .96). Of the Major injuries, the distribution of Major A, B, and C was 40.3%, 16.1%, and 43.6%, respectively.Conclusions: These subcategories enhance the National Database of Nursing Quality Indicators categorization. Using the administration manual, trained personnel can classify injurious fall severity with excellent reliability.