DOI QR코드

DOI QR Code

Meta-analysis of the Diagnostic Test Accuracy of Pediatric Inpatient Fall Risk Assessment Scales

  • Kim, Eun Joo (Department of Nursing, Gangneung-Wonju National University) ;
  • Lim, Ji Young (Department of Nursing, Inha University) ;
  • Kim, Geun Myun (Department of Nursing, Gangneung-Wonju National University) ;
  • Lee, Mi Kyung (Department of Nursing, Korea University)
  • Received : 2018.11.18
  • Accepted : 2018.12.19
  • Published : 2019.01.31

Abstract

Purpose: This study was conducted to obtain data for the development of an effective fall risk assessment tool for pediatric inpatients through a systematic review and meta-analysis of the diagnostic test accuracy of existing scales. Methods: A literature search using Medline, Science Direct, CINAHL, EMBASE, and the Cochrane Library was performed between March 1 and 31, 2018. Of 890 identified papers, 10 were selected for review. Nine were used in the meta-analysis. Stata version 14.0 was used to create forest plots of sensitivity and specificity. A summary receiver operating characteristic curve was used to compare all diagnostic test accuracies. Results: Four studies used the Humpty Dumpty Falls Scale. The most common items included the patient's diagnoses, use of sedative medications, and mobility. The pooled sensitivity and specificity of the nine studies were .79 and .36, respectively. Conclusion: Considering the low specificity of the pediatric fall risk assessment scales currently available, there is a need to subdivide scoring categories and to minimize items that are evaluated using nurses' subjective judgment alone. Fall risk assessment scales should be incorporated into the electronic medical record system and an automated scoring system should be developed.

Keywords

References

  1. Hendrich AL, Bender PS, Nyhuis A. Validation of the Hendrich II Fall Risk Model: A large concurrent case/control study of hospitalized patients. Applied Nursing Research. 2003;16(1):9-21. https://doi.org/10.1053/apnr.2003.016009
  2. Neiman J, Rannie M, Thrasher J, Terry K, Kahn MG. Development, implementation, and evaluation of a comprehensive fall risk program. Journal for Specialists in Pediatric Nursing. 2011;16(2):130-139. https://doi.org/10.1111/j.1744-6155.2011.00277.x
  3. Child Health Corporation of America, Nursing Falls Study Task Force. Pediatric falls: State of the science. Pediatric Nursing. 2009; 35(4):227-231.
  4. Shin HJ, Kim YN, Kim JH, Son IS, Bang KS. A pediatric fall-risk assessment tool for hospitalized children. Child Health Nursing Research. 2014;20(3):215-224. https://doi.org/10.4094/chnr.2014.20.3.215
  5. DiGerolamo K, Davis KF. An integrative review of pediatric fall risk assessment rools. Journal of Pediatric Nursing. 2017;34:23-28. https://doi.org/10.1016/j.pedn.2017.02.036
  6. National Evidence-based Healthcare Collaborating Agency. Systematic review of diagnostic tests. Manual Development Report. Seoul: National Evidence-based Healthcare Collaborating Agency; 2014 Apr.
  7. Jamerson PA, Graf E, Messmer PR, Fields HW, Barton S, Berger A, et al. Inpatient falls in freestanding children's hospitals. Pediatric Nursing. 2014;40(3):127-135.
  8. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557-560. https://doi.org/10.1136/bmj.327.7414.557
  9. Dwamena BA. Midas: Retouch regarding diagnostic accuracy meta-analysis [Internet]. Boston: Stata; 2014 [cited 2018 Oct 10]. Available from: http://www.stata.com/meeting/boston14/abstracts/materials/boston14_dwamena.pdf.
  10. Levene S, Bonfield G. Accidents on hospital wards. Archives of Disease in Childhood. 1991;66(9):1047-1049. https://doi.org/10.1136/adc.66.9.1047
  11. Razmus I, Wilson D, Smith R, Newman E. Falls in hospitalized children. Pediatric Nursing. 2006;32(6):568-572.
  12. Kramlich DL, Dende D. Development of a pediatric fall risk and injury reduction program. Pediatric Nursing. 2016;42(2):77-82.
  13. Harvey K, Kramlich D, Chapman J, Parker J, Blades E. Exploring and evaluating five paediatric falls assessment instruments and injury risk indicators: An ambispective study in a tertiary care setting. Journal of Nursing Management. 2010;18(5):531-541. https://doi.org/10.1111/j.1365-2834.2010.01095.x
  14. Graf E. Magnet children's hospitals: Leading knowledge development and quality standards for inpatient pediatric fall prevention programs. Journal of Pediatric Nursing. 2011;26(2):122-127. https://doi.org/10.1016/j.pedn.2010.12.007
  15. Pauley BJ, Houston LS, Cheng D, Johnston DM. Clinical relevance of the Humpty Dumpty Falls Scale in a pediatric specialty hospital. Pediatric Nursing. 2014;40(3):137-142.
  16. Zhu H, Xu H, Yang Y. Preliminary evaluation on Humpty Dumpty pediatric Falls Risk Scale. Chinese Nursing Research. 2012;26(7):1817-1820.
  17. 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. https://doi.org/10.1046/j.1440-172X.2003.00409.x
  18. Franck LS, Gay CL, Cooper B, Ezrre S, Murphy B, Chan JS, et al. The Little Schmidy Pediatric Hospital fall risk assessment index: A diagnostic accuracy study. International Journal of Nursing Studies. 2017;68:51-59. https://doi.org/10.1016/j.ijnurstu.2016.12.011
  19. Chroma J. Risk of falling in pediatric nursing. Central European Journal of Nursing and Midwifery. 2016;7(4):542-548. https://doi.org/10.15452/CEJNM.2016.07.0027
  20. Schaffer PL, Daraiseh NM, Daum L, Mendez E, Lin L, Huth MM. Pediatric inpatient falls and injuries: A descriptive analysis of risk factors. Journal for Specialists in Pediatric Nursing. 2012;17(1):10-18. https://doi.org/10.1111/j.1744-6155.2011.00315.x
  21. Cooper CL, Nolt JD. Development of an evidence-based pediatric fall prevention program. Journal of Nursing Care Quality. 2007;22(2):107-112. https://doi.org/10.1097/01.NCQ.0000263098.83439.8c

Cited by

  1. An electronic medical record-based fall risk assessment tool for pediatric inpatients in South Korea: Improved sensitivity and specificity vol.27, pp.2, 2021, https://doi.org/10.4094/chnr.2021.27.2.137
  2. A Systematic Review and Meta-Analysis of Fall Prevention Programs for Pediatric Inpatients vol.18, pp.11, 2019, https://doi.org/10.3390/ijerph18115853
  3. Evaluation of the risk of falls in hospitalized children using the GRAF PIF scale (General Risk Assessment for Pediatric Inpatient Falls Scale) vol.22, pp.3, 2019, https://doi.org/10.36290/ped.2021.050