Myers Helen, Nikoletti Sue
Centre for Nursing Research, Sir Charles Gairdner Hospital, Perth, Western Australia,
Int J Nurs Pract. 2003 Jun;9(3):158-65. doi: 10.1046/j.1440-172x.2003.00409.x.
A prospective cohort study was used to determine the reliability and validity of two fall risk assessment tools and nurses' clinical judgement in predicting patient falls. The study wards comprised two aged care and rehabilitation wards within a 570 bed acute care tertiary teaching hospital in Western Australia. Instrument testing included test-retest reliability and calculations of sensitivity, specificity, positive predictive value, negative predictive value and accuracy. The test retest reliability of all methods was good. In this setting, the three methods of assessing fall risk showed good sensitivity but poor specificity. Also, all methods had limited accuracy, and overall, exhibited an inability to adequately discriminate between patient populations at risk of falling and those not at risk of falling. Consequently, neither nurses' clinical judgement nor the fall risk assessment tools could be recommended for assessing fall risk in this clinical setting.
一项前瞻性队列研究旨在确定两种跌倒风险评估工具以及护士临床判断在预测患者跌倒方面的可靠性和有效性。研究病房包括西澳大利亚州一家拥有570张床位的急性护理三级教学医院内的两个老年护理和康复病房。工具测试包括重测信度以及敏感性、特异性、阳性预测值、阴性预测值和准确性的计算。所有方法的重测信度良好。在这种情况下，三种评估跌倒风险的方法显示出良好的敏感性，但特异性较差。此外，所有方法的准确性都有限，总体而言，无法充分区分有跌倒风险的患者群体和无跌倒风险的患者群体。因此，在这种临床环境中，不建议使用护士的临床判断或跌倒风险评估工具来评估跌倒风险。
