Browse > Article

Risk Factors for Falls in Tertiary Hospital Inpatients: A Survival Analysis  

Cho, Young Shin (Surgical Intensive Care Unit, Kosin University Gospel Hospital)
Lee, Young Ock (Surgical Intensive Care Unit, Kosin University Gospel Hospital)
Youn, Young Sun (Diabetic Practice Classroom, Kosin University Gospel Hospital)
Publication Information
Journal of Korean Critical Care Nursing / v.12, no.1, 2019 , pp. 57-70 More about this Journal
Abstract
Purpose : The purpose of this study was to identify the risk factors for falls in tertiary hospital inpatients and to suggest data for developing a nursing intervention program for preventing falls. Methods: Data were collected between January 1, 2017, to December 31, 2017. Kaplan-Meier estimation was used to measure the survival rate, and the log-rank test was used for the differences between the fall group and the non-fall group. The Cox proportional hazards model was used to identify the risk factors for falls. Results: The incidence rate of falls for the inpatients was 1.2 cases per 1,000 days of hospitalization. The risk factors for falls were more likely to be found among those who were aged ${\geq}81$, had not undergone surgery, had poor joint motion, had unsteady gait, needed help or supervision, used assistive devices, had comorbidity, and took at least two drugs. Conclusion: For the inpatients, the risk factors for falls included age, surgery, comorbidity, medication that could change mobility, joint motion, and use of patient care equipment. It is necessary to give special attention to inpatients who have any of these risk factors and to develop a falls risk assessment tool.
Keywords
Accidental falls; Tertiary care centers; Inpatients; Survival analysis; Risk factors;
Citations & Related Records
Times Cited By KSCI : 4  (Citation Analysis)
연도 인용수 순위
1 Bae, J. M. (2012). An illustrated guide to medical statistics using SPSS. Seoul: Hannare.
2 Choi, E. H., Ko, M. S., Yoo, C. S., & Kim, M. K. (2017). Characteristics of fall events and fall risk factors among inpatients in general hospitals in Korea. Journal of Korean Clinical Nursing Research, 23(3), 350-360.   DOI
3 Choi, E. J., Lee, Y. S., Yang, E. J., Kim, J. H., Kim, Y. H., & Park, H. A. (2017). Characteristics and risk factors for falls in tertiary hospital inpatients. Journal of Korean Academy of Nursing. 47(3), 420-430.   DOI
4 Cox, J., Thomas-Hawkins, C., Pajarillo, E., DeGennaro, S., Cadmus, E., & Martinez, M. (2015). Factors associated with falls in hospitalized adult patients. Applied Nursing Research, 28(2), 78-82.   DOI
5 Evans, D., Hodgkinson, B., Lambert, L., & Wood, J. (2001). Falls risk factors in the hospital setting: A systematic review. International journal of nursing practice, 7(1), 38-45.   DOI
6 Gringauz, I., Shemesh, Y., Dagan, A., Israelov, I., Feldman, D., Pelz-Sinvani, N., . . . Segal, G. (2017). Risk of falling among hospitalized patients with high modified Morse scores could be further stratified. BMC health services research, 17(1), 721.   DOI
7 Kim, C. G., & Suh, M. J. (2002). An analysis of fall incidence rate and its related factors of fall in inpatients. Journal of Korean Society of Quality Assurance in Health Care, 9(2), 210-228.
8 Hendrich, A. L., Bender, P. S., & Nyhuis, A. (2003). Validation of the Hendrich II fall risk model: A large concurrent case/control study of hospitalized patients. Applied Nursing Research, 16(1), 9-21.   DOI
9 Jang, I. S., & Lee, S. G. (2014). Fall risk factors and characteristics of an acute hospital setting across clinical departments. Journal of the Korean Academy of Fundamentals of Nursing, 21(3), 264-274.   DOI
10 Kang, Y. O., & Song, R. (2015). Identifying characteristics of fall episodes and fall-related risks of hospitalized patients. Journal muscle Joint Health, 22(3), 149-159.   DOI
11 Kim, E. K., Lee, J. C., & Eom, M. R. (2008). Falls risk factors of inpatients. Journal of Korean Academy of Nursing, 38(5), 676-684.   DOI
12 Morse, J. M. (2009). Preventing patient falls: Establishing a fall intervention program (2nd ed.). New York, NY: Springer Publishing Company.
13 Kim, K. S., Kim, J. A., Choi, Y. K., Kim, Y. J., Park, M. H., Kim, H. Y., & Song, M. S. (2011). A comparative study on the validity of fall risk assessment scales in Korean hospitals. Asian Nursing Research, 5(1), 28-37.   DOI
14 Kim, Y. S., & Choi-Kwon, S. (2013). Fall risk factors and fall risk assessment of inpatients. Korean Journal of Adult Nursing, 25(1), 74-82.   DOI
15 Lee, J. E., & Stokic, D. S. (2008). Risk factors for falls during inpatient rehabilitation. American journal of physical medicine & rehabilitation, 87(5), 341-353.   DOI
16 Morse, J. M., Morse, R. M., & Tylko, S. J. (1989). Development of a scale to identify the fall-prone patient. Canadian Journal on Aging, 8(4), 366-377.   DOI
17 Oliver, D., Healey, F., & Haines, T. P. (2010). Preventing falls and fall-related injuries in hospitals. Clinics in geriatric medicine, 26(4), 645-692.   DOI
18 National Patient Safety Agency. (2007). Slips, trips and falls in hospital. Retrieved October 5, 2017, from http://www.nrls.npsa.nhs.uk/resources/?entryid45=59821
19 Needham, D. M., Davidson, J., Cohen, H., Hopkins, R. O., Weinert, C., Wunsch, H., . . . Brady, S. L. (2012). Improving long-term outcomes after discharge from intensive care unit: Report from a Stakeholders' conference. Critical care medicine, 40(2), 502-509.   DOI
20 Nunan, S., Brown Wilson, C., Henwood, T., & Parker, D. (2018). Fall risk assessment tools for use among older adults in long-term care settings: A systematic review of the literature. Australasian journal on ageing, 37(1), 23-33.   DOI
21 Severo, I. M., Almeida, M. D. A., Kuchenbecker, R., Vieira, D. F. V. B., Weschenfelder, M. E., Pinto, L. R. C., . . . Panato, B. P. (2014). Risk factors for falls in hospitalized adult patients: An integrative review. Revista da Escola de Enfermagem da USP, 48(3), 540-554.   DOI
22 Poe, S. S., Cvach, M., Dawson, P. B., Straus, H., & Hill, E. E. (2007). The Johns Hopkins fall risk assessment tool: Postimplementation evaluation. Journal of nursing care quality, 22(4), 293-298.   DOI
23 Poe, S. S., Cvach, M. M., Gartrell, D. G., Radzik, B. R., & Joy, T. L. (2005). An evidence-based approach to fall risk assessment, prevention, and management: Lessons learned. Journal of Nursing Care Quality, 20(2), 107-116.   DOI