Comparison of content coverage of domestic and international inpatient falls prevention guidelines using standard nursing terminologies; [표준 용어체계를 이용한 국내외 입원 환자 낙상간호 실무지침 비교 분석]

초록

Purpose: The purpose of this study was to compare the content of the falls prevention guideline developed by Korean Hospital Nurses' Association (KHNA) in 2008 with the seven guidelines recommended by The Joint Commission. Methods: The contents of the eight guidelines were categorized into eight assessment, eight intervention, and two outcome elements that were considered core concepts of individual nursing activities. Concept-level comparisons were conducted using the International Classification for Nursing Practice, and the Logical Observation Identifiers, Names, and Codes. Two researchers independently examined the content coverage of each guideline and assigned 1 point to included content, 0 to excluded content, and 0.5 to similar content that was ambiguous in terms of a broader expression. The scores were compared, with discordance among raters resolved through consensus-based discussions. Results: The communication element in the assessment area was missing from the KHNA guideline, while five elements of pathophysiologic, mental/cognitive, therapeutic, and post-fall assessments showed lack of content. Although there were no missing elements in the intervention area, the three elements of staff communication, risk-targeted, and post-fall interventions showed considerable lack of content compared to the other guidelines. In terms of outcomes, the severity of fall-related injury was omitted, and the facility's policy on falls prevention was not addressed. Conclusion: Many nursing elements and key concepts were missing from the KHNA guideline, and its content was not comprehensive. This suggests that the current guideline needs to be revised urgently, and the points identified in this study should be considered a high priority. © 2018 Korean Society of Adult Nursing.

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