• Title/Summary/Keyword: Accidental falls

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Risk Factors for Pediatric Inpatient Falls (아동 입원환자의 낙상위험 예측요인)

  • Cho, Myung Sook;Song, Mi Ra;Cha, Sun Kyung
    • Journal of Korean Academy of Nursing
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    • v.43 no.5
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    • pp.595-604
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    • 2013
  • Purpose: The purpose of this study was to identify risk factors for pediatric inpatients falls. Methods: The study was a matched case-control design. The participants were 279 patients under the age of 6 who were admitted between January 1, 2004 and December 31, 2009. Through chart reviews, 93 pediatric patients who fell and 186 ones who did not fall were paired by gender, age, diagnosis, and length of stay. Five experts evaluated the 38 fall risk factors selected by the researchers. Results: In a general hospital, pediatric patients with secondary diagnosis, tests that need the patient to be moved, intravenous lines, hyperactivity, anxiolytics, sedatives and hypnotics, and general anesthetics showed significance for falls on adjusted-odds ratios. Conditional logistic regression analysis was performed to elucidate the factors that influence pediatric inpatient falls. The probability of falls increased with hyperactivity and general weakness. Patients who didn't have tests that required them to be moved and intravenous line had a higher risk of falls. Conclusion: These findings provide information that is relevant in developing fall risk assessment tools and prevention programs for pediatric inpatient falls.

Predictive Effects of Previous Fall History on Accuracy of Fall Risk Assessment Tool in Acute Care Settings (기존 낙상위험 사정 도구의 낙상 과거력 변인 효과)

  • Park, Ihn Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.19 no.4
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    • pp.444-452
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    • 2012
  • Purpose: To explore the usefulness of previous fall history as a triage variable for inpatients. Methods: Medical records of 21,382 patients, admitted to medical units of one tertiary hospital, were analyzed retrospectively. Inpatient falls were identified from the hospital's self-report system. Non-falls in 1,125 patients were selected by a stratified matching sampling with 125 patients with falls (0.59%). A comparative and predictive accuracy analysis was conducted to describe differences between the two groups with and without a history of falls. Logistic regression was used to measure the effect size of the fall history. Results: The fall history group showed higher prevalence by 9 fold than the non-fall history group. The relationships between falls and relevant variables which were significant in the non-fall history group, were not significant for the fall history group. Falls in the fall history group were 25 times more likely than in the non-fall group. Predictive accuracy of the risk assessment tool showed almost zero specificity in the fall history group. Conclusion: The presence of fall history, the fall prevalence, variables relevant to falls, and the accuracy of the risk tool were different, which support the usefulness of the fall history as a triage variable.

Evaluation of the Humpty Dumpty Falls Scale: An Analysis of Electronic Medical Records (소아 낙상위험 측정도구 (Humpty Dumpty Falls Scale) 평가: 전자의무기록을 이용하여)

  • Cho, Yun Hee;Kim, Young Ju
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.2
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    • pp.142-150
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    • 2019
  • Purpose: The aim of this study was to evaluate the efficiency of the Humpty Dumpty Falls Scale as one of the falls risk assessment tools, and also to evaluate risk factors as predictors of falls in pediatric patient populations. Methods: In a retrospective, case-control design with data from the electronic medical records of 13 pediatric patients who fell and 1,941 who did not fall before matching and 429 who did not fall after matching by gender, age, diagnosis, and length of stay. Results: All the variables showed no significant differences after matching. At the cutoff score of 13, sensitivity, specificity, negative and positive predictive values were 92.3%, 37.1%, 99.9%, and 0.01%, respectively. The area under the Receiver Operating Characteristics was 0.597. The results from the logistic regression showed that the pediatric inpatient population who had higher risk scores was significantly associated with falls. The odds ratios ranged from 1.31 to 4.71 with 90% confidence interval. Conclusion: The saturation impairments criterion as one of the diagnostic parameter was negatively associated with falls, but the relative risk score was higher than the other criteria. Therefore, it seems that the diagnostic parameter seems to be required to verify results through large sample studies.

Falls Risk Factors of Inpatients (입원환자의 낙상 위험 예측 요인)

  • Kim, Eun-Kyung;Lee, Jae-Chang;Eom, Mi-Ran
    • Journal of Korean Academy of Nursing
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    • v.38 no.5
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    • pp.676-684
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    • 2008
  • Purpose: The purpose of this study was to identify the risk factors for falls and to suggest data for developing a program for preventing falls. Methods: This was a case-control study in five university hospitals and a general hospital. In total, 216 patients over the age of 18 yr admitted from January 1 to December 31, 2007 participated. One hundred eight patients with experience of falling were matched by gender, age level, diagnosis, and length of stay with 108 patents with no experience of falling admitted on the same unit. A quality assurance coordinator nurse in each hospital examined 35 fall risk factors developed by researchers. Results: In acute hospitals, history of falls, orientation ability, dizziness or vertigo, general weakness, urination problems, transfer/mobility difficulty, walking dependency, impatience, benzodiazepines, diuretics, and vasodilators showed significance on adjusted-odds ratios for fall. Logistic regression analysis was performed to elucidate the factors that influence falls. The probability of falls was increased by dizziness/vertigo, general weakness, and impatience/agitation. Conclusion: This finding can be used as a useful resource in developing nursing intervention programs to predict and prevent the falls of inpatients.

Medication Use as a Risk Factor for Falls among Hospitalized Stroke Patients (노인전문병원에 입원한 뇌졸중환자의 복용약물과 관련된 낙상 위험요인)

  • Sohng Kyeong-Yae;Cho Ok-Hee;Park Mi-Hwa
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.1
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    • pp.60-67
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    • 2006
  • Purpose: To identify the relationship between medication use and falls among hospitalized stroke patients. Method: The medical records of 472 patients with strokes were reviewed using a questionnaire on falling developed by the authors. Frequencies, percentages, means, standard deviations, and t-test and ${\chi}^2$-test, multiple logistic regression analysis were done using the SAS program. Results: The rate for falls by the patients during their stay in the hospital was 14.0%. The length of stay was longer and the morbidity duration of stroke shorter in the fall group than in the non-fall group. The use of sedatives, laxatives, and antidepressants was a significant predictor of falls and was associated with increase likelihood of falling(1.82, 1.81, 1.75 times respectively). Conclusion: In hospitalized stroke patients, there was a significant association between the use of sedatives, laxatives, antidepressants and falls. The number and kinds of ingested drugs was also associated with falls. It is necessary to further analyze the causes of falls based on results of the present study.

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The Effects of Symptom Experiences and Depression on Falls Efficacy in Elderly Patients Undergoing Chemotherapy (항암화학요법을 받는 노인의 증상경험과 우울이 낙상 효능감에 미치는 영향)

  • Hwang, Do Hyun;Jung, Dukyoo
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.2
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    • pp.189-197
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    • 2019
  • Purpose: The purpose of this study was to identify the effects of symptom experience and depression on the falls efficacy of elderly patients who were undergoing chemotherapy. Methods: The questionnaires were administered to 105 elderly patients over 65 years hospitalizing for chemotherapy from October 25 to December 30, 2018. The data were analyzed by descriptive statistics, t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson's correlations and Multiple Linear Regression, ursing an SPSS/WIN 22.0 program. Results: Falls efficacy was negatively correlated with the symptom experience (r=-.58, p<.001), and depression (r=-.57, p<.001). Symptom experience and depression were positively correlated (r=.72, p<.001). The significantly influential factors of falls efficacy were age (${\beta}=-.34$, p<.001), symptom experience (${\beta}=-.24$, p=.022), and the history of falls (${\beta}=-.15$, p=.040), explaining 57.0% of the variance in falls efficacy. Conclusion: The main findings of this study can be used as the foundation for developing programs to increase the falls efficacy of elderly patients undergoing chemotherapy.

Accidental Mortality and Compensation Payment in School Activities among Elementary, Middle and High School Students in Seoul over Twenty Years (1988-2007) (서울시 초.중.고등학교의 20년간(1988-2007) 교육활동에서 학생의 사고 사망률 및 보상비용)

  • Shin, Sun-Mi;Lee, Hee-Woo
    • Journal of Korean Academy of Nursing
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    • v.42 no.2
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    • pp.248-257
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    • 2012
  • Purpose: The purpose of this study was to identify accidental mortality during school activities of students in elementary, middle or high school in Seoul and consequent compensation payment. Methods: Fifty-eight students died due to accidents during the period 1988 through 2007. Data were obtained from the Seoul School Safety and Insurance Association, and Seoul Metropolitan Office of Education. Chi-square, t-test, and ANCOVA were used in the data analysis. Results: Among students, 75.9% were male and 37.9% were high school students. Accidental mortality was 1.61 per one million students (2.33 for male, and 0.82 for female students, and 0.93, 2.13 and 2.31 for elementary, middle and high school students, respectively). Mortality caused by drowning and falls per one million student was 0.85 and 0.74 for male, and 0.23 and 0.35 for female students. After age, year and cause were adjusted using ANCOVA, the mean compensation payment was 40,615 thousand won for male, and 62,000 thousands for female students. Highest compensation payment was 127,137 thousand for cerebral concussion after age, gender, year and cause were adjusted. Conclusion: To decrease student accidental mortality, especially drowning and falls, development of efficient safety-enforcing education is essential to prevent injuries and avoid preventable compensation costs.

Fall Experience and Risk Factors for Falls among the Community-dwelling Elderly (지역사회 재가노인의 낙상경험과 낙상위험요인)

  • Kim, Young Hee;Yang, Kyung Hee;Park, Kum Sook
    • Journal of muscle and joint health
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    • v.20 no.2
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    • pp.91-101
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    • 2013
  • Purpose: The purpose of this study was to investigate the experience of falls and identify risk factors associated with falls. Methods: The participants were 233 community-dwelling elderly people in two cities. Data were collected by interviewing the elderly with structured questionnaires from May to June, 2012. For data analysis, descriptive statistics and multiple logistic regression were performed using SPSS version 17.0. Results: Age, educational level, living arrangement, health status, the use of assistive devices, the number of medication, hypertension, arthralgia, dizziness, fall efficacy, fear of falling, activity of daily living, and quality of life were significant associated with fall experience. Through multiple logistic regression analysis, arthralgia, dizziness, fall efficacy, and fear of falling were identified as significant predictors of falls. Conclusion: It is important to identify the risk factors for falls among the elderly living in community. Fall prevention interventions should be multifactorial, especially for the elderly who were identified as the high risk group.

Differences of Prevalence and Associated Factors of Falls in Community-Dwelling Older People with Hypertension (고혈압이 있는 재가노인의 낙상발생의 차이 및 영향요인)

  • Jang, Gun-Ja;Jeon, Eun-Young;Kwon, Byung-Hyun
    • Journal of Korean Public Health Nursing
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    • v.24 no.2
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    • pp.302-310
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    • 2010
  • Purpose: A comprehensive analysis of demographical, disease, functional status and fall risk related factors identified factors associated with falls in elderly hypertensive. Method: A descriptive research design was used. The participants were 124 persons aged 65 years or older registered at the community center in Daegu city. The data were collected from October, 2008 to February, 2009. Frequency, Fisher's exact test, $X^2$-test, t-test, and logistic regression were done using the SPSS V17.0. Results: Ninety (72.6%) subjects had experienced falls. The occurrence differed according to number of medications, activities of daily living and competence of vision. Logistic analysis revealed number of medication and impaired vision as independent risk factors for subsequent falls. Conclusion: Supportive nursing for the elderly needs to focus on dizziness and impaired vision to prevent falls in community-dwelling elderly with hypertension.

Incidence of Falls and Risk Factors of Falls in Inpatients (입원환자의 낙상 실태 및 위험요인 조사연구)

  • Yoon, Soo-Jin;Lee, Chun-Kyon;Jin, In-Sun;Kang, Jung-Gu
    • Quality Improvement in Health Care
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    • v.24 no.2
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    • pp.2-14
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    • 2018
  • Purpose: The objective of this study was to report the incidence of falls in hospitals and analyze the risk factors for falls. Methods: This study used data on 1,216 patients who experienced falls from 2015 to 2017 during their hospitalization. The data was collected from the falls incident reports and patient' electronic medical record of hospital. Data were analyzed with descriptive statistics using Chi-square test, Fisher's exact test and multiple Poisson regression analysis with the SAS 9.4 Results: The incidence of falls was 1.38 per 1,000 patients days (2015), 1.81 per 1,000patients days (2016) and 1.99 per 1,000patients days (2017). The incidence of injury caused by falls (level III~V) was 0.05 per 1,000patients days (2015), 0.04 per 1,000patients days (2016) and 0.06 per 1,000patients days (2017). The largest number of falls occurred during night shift (42.5%), specifically in the patients' room (70.8%), and medical unit (66.0%). Average age of fallers was 69.1 years and 61.7% of them were older than 71 years. CCI and the patient's department have statistically significant differences in injury or injury levels from falls, but the integrated nursing care services had no significant difference in injury or injury levels from falls. Conclusion: The result of this study can be used as a reference for establishing a fall prevention strategy for hospitalized patients by presenting index values such as the fall rate.