An electronic medical record-based fall risk assessment tool for pediatric inpatients in South Korea: Improved sensitivity and specificity

Abstract

Purpose: To develop a fall risk assessment tool to predict fall risk in pediatric inpatients.Methods: Three tools widely used in clinical practice (Humpty Dumpty Fall Scale, General Risk Assessment for Pediatric Inpatient Falls, and Seoul National University Hospital Pediatric Fall Risk Scale) were examined, and assessment items were extracted. Employing a case-control design, 29 children who experienced falls during hospital stays were selected as the "fall" group, and a control group (93 children) was selected based on age and sex matching. The sensitivity, specificity, and positive and negative predictive values of the newly developed tool ("Newfs-PI") were analyzed.Results: The Newfs-PI consisted of seven items: age, activity, history of falls, length of hospital stay, and medication. The total score ranged from 0 to 15. Its sensitivity and specificity were 62.07% and 74.19%, respectively.Conclusion: The Newfs-PI has high specificity and sensitivity, which are essential for a fall risk assessment tool that complements existing tools. These values are high relative to those of existing assessment tools and satisfy both sensitivity and specificity criteria. As the EMR enables monitoring of the components of the Newfs-PI, the tool can be used as a fall risk assessment and prevention scale for pediatric inpatients.

Escala Humpty Dumpty: adaptação transcultural e validação para cultura brasileira

“…(25) Na avaliação das propriedades de medida, os coeficientes de confiabilidade foram semelhantes a de outros estudos que avaliaram a escala (Kappa>0,80). (6,8,14) A avaliação da validade demonstra se o instrumento realmente mensura o risco de queda entre crianças e adolescentes. Para isso, os escores da versão brasileira da HDFS foram correlacionados com os domínios do Instrumento de Classificação de Pacientes Pediátricos e apresentaram correlações significantes com os domínios Paciente e Procedimentos terapêuticos -confirmando as hipóteses estabelecidas.…”

“…A HDFS foi desenvolvida com o objetivo de classificar crianças e adolescentes de acordo com o risco para queda, no ambiente hospitalar e ambulatorial, e tem demonstrado adequada confiabilidade interobservadores (Kappa>0,80) e sensibilidade acima de 70%; entretanto, com baixa especificidade (<40%). (6,7,(8)(9)(10)(11)(12)(13)(14)(15)(16) Considerando que não foram identificados, no Brasil, instrumentos específicos e validados para avaliar o risco de quedas em crianças e adolescentes, o contexto da segurança do paciente e a necessidade de avaliar o risco de quedas para implementação and significant correlations were found between The Humpty Dumpty Scale and the Patient (r=0.5184; p<0.0001) and Therapeutic Procedures (r=0.2143; p<0.0332) domains of the patient classification instrument. With the Family domain (r=0.0676; p=0.5060), no significant relationships were achieved.…”

Fall prevention in a pediatric unit: a best practice implementation project

“…The authors concluded that the more specific an assessment tool, the greater its accuracy in predicting falls. 11 Evidence was also gained from one level III source and one level IV source. The level III source was a quality improvement project that sought to decrease harm resulting from pediatric falls by implementing a fall bundle with elements such as ensuring a safe environment for patients, communicating about fall risk patients with staff, and implementing tools to mitigate fall occurrence.…”

“…The fifth study, a retrospective case-control study, focused on developing a new fall risk assessment tool by evaluating three commonly used fall risk tools. The authors concluded that the more specific an assessment tool, the greater its accuracy in predicting falls 11 …”

Development of an evidence‐based care bundle protocol for preventing falls in hospitalized children: Delphi study and trial test

“…Falls are the most common type of adverse events reported for hospitalized children (Alemdaroglu et al, 2017 ; Fujita et al, 2013 ; Lee et al, 2013 ), which can cause serious harm to paediatric patients (AlSowailmi et al, 2018 ; Feuerlicht et al, 2020 ; Kim & Lee, 2021 ), and increase the length of stay (Almis et al, 2017 ). As a result, falls of inpatient children are an important issue as part of initiatives to prevent inpatient safety accidents (Kim, Lim, et al, 2021 ).…”