A study on the development of a model to identify patients at high risk for falls and development of a risk score based on Nursing Need Degree

Abstract

“Nursing Need Degree （NND）” are recorded every day in patient charts.　In this study, we developed a model to identify patients at high risk for falls and also developed a risk score based on NND, and evaluated their usefulness.　The study involved patients who were admitted to our hospital in fiscal year 2016.　Factor analysis was conducted to use NND evaluation items in the development of the risk score.　Logistic regression analysis to determine the influence of falls was performed using independent variables, including NND evaluation items and patient characteristics, to create a risk score.　The risk score was compared between “patients with falls” and “patients without falls”.　Two hundred fifty-four （2.5%） patients had falls, and 9,894 （97.5%） patients had no fall.　Fifteen evaluation items could identify patients at high risk for falls with high accuracy （area under the curve ［AUC］ = 0.75, p<0.01）.　Furthermore, there was a significant difference in the risk score between the two groups （3.7 vs 1.4, p<0.05）.　Identification of patients at high risk with NND, whose data are recorded on a daily basis, will lead to efficient fall prevention measures in hospital care, which is becoming increasingly more relevant with the aging of the population.