两种产科人群跌倒风险评估工具的比较分析。

Nursing for Women''s Health Pub Date : 2025-04-01 DOI:10.1016/j.nwh.2024.10.005

Anna Weigand, Julie Kathman, Janet Colton, James Davis

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引用次数: 0

摘要

目的：探讨莫尔斯跌倒量表（MFS）与产科跌倒风险评估系统（OFRAS）预测产科患者跌倒风险的相对准确性。设计：回顾性比较分析产科住院患者的MFS和OFRAS。环境：夏威夷一所拥有560张床位的城市教学医院。参与者：85份因分娩住院的记录。方法：采用R软件包4.0.1版和SAS 9.4版进行充分的功率建模和统计分析。随后，对入院日期相似的17例秋季记录与68例非秋季记录（1:4）的比例进行了审查。研究人员收集了MFS评分/风险水平和所需的数据点，以获得OFRAS跌倒风险评分/水平。采用MFS和OFRAS作为跌倒的预测因子，拟合Logistic回归模型。结果以95%置信区间的比值比和p值表示，以检验统计显著性。根据logistic回归结果得出受试者工作特征（ROC）曲线，并绘制图表进行比较。计算ROC曲线下面积（auroc），以显示风险评估工具的特异性和敏感性。结果：85名孕妇或产后患者的数据被纳入样本。对auroc的分析表明，OFRAS比MFS对产科患者更敏感和特异性。与MFS相比，OFRAS在预测跌倒方面具有显著性（p < 0.001）（p = 0.40）。在单独的条件逻辑回归模型中检验了跌倒分数和跌倒之间的关联。结论：OFRAS在预测跌倒风险方面具有较高的敏感性和特异性。MFS在产科跌倒风险预测方面的表现与随机机会相似。使用针对特定人群的工具，有可能更好地预测患者跌倒，保护工作人员免受与患者跌倒相关的伤害，并降低组织风险。

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Comparative Analysis of Two Fall Risk Assessment Tools in the Obstetric Population

Objective

To examine the relative accuracy of the Morse Fall Scale (MFS) and the Obstetric Fall Risk Assessment System (OFRAS) in predicting obstetric patients’ fall risk.

Design

Retrospective comparative analysis of the MFS and the OFRAS in obstetric inpatients.

Setting

A 575-bed urban teaching hospital in Hawaii.

Participants

Eighty-five records of people hospitalized for childbirth.

Methods

Adequate power modeling and statistical analyses were completed using the programs R packages Version 4.0.1 and SAS Version 9.4. Subsequently, a ratio of 17 fall records to 68 nonfall records (1:4) with similar dates of admission were reviewed. Investigators collected the MFS score/risk level as documented and the required data points to obtain the OFRAS fall risk score/level. Logistic regression models were fit using the MFS and OFRAS as predictors of falls. Results are expressed as odds ratios with 95% confidence intervals and p values to test for statistical significance. Receiver operating characteristic (ROC) curves were derived from logistic regression results and graphed to compare the instruments. Areas under ROC curve (AUROCs) were calculated to display the specificity and sensitivity of the risk assessment tools.

Results

Data for 85 pregnant or postpartum people were included in the sample. Analysis of AUROCs demonstrated that the OFRAS is more sensitive and specific for obstetric patients than the MFS. The OFRAS showed significance (p < .001) in predicting falls compared to the MFS (p = .40). Associations between fall scores and falls were examined in separate conditional logistic regression models.

Conclusion

The OFRAS demonstrated higher sensitivity and specificity in fall risk prediction. The MFS performed similarly to random chance regarding obstetric fall risk prediction. The potential exists to better anticipate patient falls, protect staff from injury related to patient fall, and decrease organizational risk using a population-specific tool.

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来源期刊

Nursing for Women''s Health Nursing-Nursing (all)

CiteScore

2.10

自引率

0.00%

发文量

期刊介绍： Nursing for Women"s Health publishes the most recent and compelling health care information on women"s health, newborn care and professional nursing issues. As a refereed, clinical practice journal, it provides professionals involved in providing optimum nursing care for women and their newborns with health care trends and everyday issues in a concise, practical, and easy-to-read format.