某醫學中心加護病房運用Hendrich II跌倒風險評估量表之現況探討

Investigation on the status quo of using Hendrich II Assessment Tool in an Intensive Care Unit of Medical Center

王鳳琴(Fong-Chin Wang) ； 胡潔瑩(Chieh-Ying Hu) ； 廖玉美(Yu-Mei Liao) ； 陳淑惠(Sue-Hui Chen) ； 陳美杏(Mei-Hsing Chen) ； 陳幼梅(Yao-Mei Chen) ； 李育珮(Yu-Pei Li) ； 張偉洲(Wei-Chou Chang)

《醫務管理期刊》 19卷3期 (2018/09) Pp. 249-261

https://doi.org/10.6174/JHM.201809_19(3).249

摘要

目的：探討Hendrich II跌倒風險評估量表在個案醫院加護病房之使用情形。方法：採病歷回溯性研究，檢視研究期間跌倒風險評估紀錄，研究對象為所有入住成人加護病房之病人；統計方法為描述性統計及診斷分析（diagnostic test analysis）。結果：2016年10月至2017年6月共有1652人次入住成人加護病房，扣除未曾接受跌倒評估及未滿20歲共197人次，共有1455人次；研究結果敏感性為0%，特異性為92.4%，陽性預測率為0%，陰性預測率為99.7。結論：Hendrich II量表評估項目總分為16分，評估≧ 5分即為跌倒高風險，但加護病房病人的疾病特性可能使量表評分偏低，評估工具均有其限制性，不能完全取代臨床人員的專業判斷，若評估工具未篩檢出某些特殊情形或病人為跌倒高風險，但經臨床專業評估認為有跌倒的可能，仍應給予跌倒預防措施介入，才能有效預防病人跌倒。

關鍵字

跌倒風險評估量表 ； 加護病房 ； Hendrich II

並列摘要

Objectives: Investigating the use of Hendrich II Fall Risk Assessment Tool in an Intensive Care Unit Methods: A retrospective study of medical records to review fall risk assessment during the study was conducted. Study subjects were patients admitted in intensive care unit (ICU) with diagnostic test analysis as statistical method. Results: 1652 patients were admitted to adult ICU from October 2016 to June 2017, of which 197 patients were either aged under 20 or had never received fall risk assessment during hospitalization. Sensitivity and specificity of this study were 0% and 92.4% respectively; positive and negative predictive values were 0% and 99.7% respectively. Conclusions: The total score of Hendrich II assessment tool is 16 points, of which a score of five points or higher is identified as a high risk of falling; however, the assessment score may have dropped due to the disease characteristics of patients in ICU. The assessment tool has its restriction and it cannot replace clinical staffs' professional judgement entirely. If under some specific circumstances, or the patient was not identified as high fall risk by an assessment tool, fall prevention precaution is still required to provide to patients in order to prevent them from falling effectively shall the clinical professional assessment believes that there is a possibility of falling.

並列關鍵字

fall risk assessment ； ICU ； Hendrich II

參考文獻

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