• Title/Summary/Keyword: Fall risk

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Development of Fall Assessment Scale in Adult Inpatients (한국형 성인 환자 낙상위험 사정도구 개발)

  • Choi, Eun Hee;Ko, Mi Suk;Hong, Sang Hee;Kim, In Sook
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.2
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    • pp.179-188
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    • 2019
  • Purpose: The purpose of this study was to develop a valid Adult Fall Assessment Scale Korean version (FAS-K) for inpatients in general hospitals in Korea. Methods: This a 14 item FAS-K was developed based on a review of national and international research and expert opinions in related field. Interrater reliability of FAS-K was analyzed using the ICC (Intraclass Correlation Coefficients). To examine the validity of FAS-K, a CVI (Content Validity Index), the Pearson correlation coefficients between FAS-K and two widely used scales, the Morse Fall Scale (MFS) and the Johns Hopkins Hospital Fall Risk Assessment Tool (JHFRAT), and the Mann-Whitney test were used. Results: The ICC was .958. The CVI ranged from .70 to 1.00. The FAS-K was significantly associated with the MFS (r=.74, p<.001) and with the JHFRAT (r=.87, p<.001), verifying the concurrent validity of FAS-K. As for the construct validity of FAS-K, significant differences between the fall and non-fall groups were found not only in the MFS (Z=-3.23, p=.001) but also in the FAS-K (Z=-3.10, p=.002). Conclusion: The findings indicate that the FAS-K is a reliable fall risk assessment tool with high validity.

Effect of Preexisting Musculoskeletal Diseases on the 1-Year Incidence of Fall-related Injuries

  • Lee, Won-Kyung;Kong, Kyoung-Ae;Park, Hye-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.45 no.5
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    • pp.283-290
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    • 2012
  • Objectives: People who have chronic diseases, as well as gait imbalance or psychiatric drug use, may be susceptible to injuries from falls and slips. The purpose of this study was to evaluate the effect of musculoskeletal diseases on incidental fall-related injuries among adults in Korea. Methods: We analyzed data from the 4th Korea National Health and Nutrition Examination Survey (2007-2009), which are national data obtained by a rolling survey sampling method. The 1-year incidence of fall-related injuries was defined by health service utilization within the last year due to injury occurring after a slip and fall, and musculoskeletal diseases included osteoarthritis, rheumatoid arthritis, osteoporosis, and back pain. To evaluate the effects of preexisting musculoskeletal diseases, adults diagnosed before the last year were considered the exposed group, and adults who had never been diagnosed were the unexposed group. Results: The weighted lifetime prevalence of musculoskeletal disease was 32 540 per 100 000 persons. Musculoskeletal diseases were associated with a higher risk of fall-related injury after adjustment for sex, age, residence, household income, education, occupation, visual disturbance, paralysis due to stroke, and medication for depression (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.03 to 1.93). As the number of comorbid musculoskeletal diseases increased, the risk of fall-induced injuries increased (p-value for trend <0.001). In particular, patients who had any musculoskeletal condition were at much higher risk of recurrent fall-related injuries (OR, 6.20; 95% CI, 1.06 to 36.08). Conclusions: One must take into account the risk of fall-related injuries and provide prevention strategies among adults who have musculoskeletal diseases.

Meta-analysis of the Diagnostic Test Accuracy of Pediatric Inpatient Fall Risk Assessment Scales

  • Kim, Eun Joo;Lim, Ji Young;Kim, Geun Myun;Lee, Mi Kyung
    • Child Health Nursing Research
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    • v.25 no.1
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    • pp.56-64
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    • 2019
  • Purpose: This study was conducted to obtain data for the development of an effective fall risk assessment tool for pediatric inpatients through a systematic review and meta-analysis of the diagnostic test accuracy of existing scales. Methods: A literature search using Medline, Science Direct, CINAHL, EMBASE, and the Cochrane Library was performed between March 1 and 31, 2018. Of 890 identified papers, 10 were selected for review. Nine were used in the meta-analysis. Stata version 14.0 was used to create forest plots of sensitivity and specificity. A summary receiver operating characteristic curve was used to compare all diagnostic test accuracies. Results: Four studies used the Humpty Dumpty Falls Scale. The most common items included the patient's diagnoses, use of sedative medications, and mobility. The pooled sensitivity and specificity of the nine studies were .79 and .36, respectively. Conclusion: Considering the low specificity of the pediatric fall risk assessment scales currently available, there is a need to subdivide scoring categories and to minimize items that are evaluated using nurses' subjective judgment alone. Fall risk assessment scales should be incorporated into the electronic medical record system and an automated scoring system should be developed.

Exploring the Utility of the ICNP based Electronic Nursing Records as a Research Source for Inpatients' Falls (입원환자의 낙상발생 연구 자료원으로서의 국제간호실무분류체계 기반 전자간호기록의 유용성)

  • Cho, In-Sook;Park, Inh-Sook;Kim, Eun-Man
    • Perspectives in Nursing Science
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    • v.5 no.1
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    • pp.33-43
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    • 2008
  • Objective: This study explored the reuse of data captured into an electronic nursing record system using the International Classification for Nursing Practice to support nursing research of inpatient's falls. Methods: Risk factors relevant to inpatients falls ;n an acute setting were identified from the literature review. Four risk assessment tools and two risk identification studies were selected. To examine the availability of coded data in an electronic nursing record system for the identified fall fisk factors, we reviewed 11.319 hospital-day records of 118 patients who were reported by the self-report system. Results: We identified 24 fall risk factors of five categories from the literature review, which were used to identify the standard nursing statements addressing fall risks. One hundred thirty five nursing statements were searched from the hospital's nursing data dictionary of statements and were matched with 14 fall fisk factors. Using the 135 statements. we found that mental status, catheter of drip in situ, abnormal gait, insomnia, surgical procedure. and dizziness/vertigo appeared frequently in the nursing records of inpatients with fall s. Also we found 6 risk factors more through the record review. Conclusion: The electronic records would be a good research source for inpatients' falls. Specifically international classification for nursing practice based nursing record system has the potential for promoting clinical researches.

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Fall Risk in Low-Income Elderly People in One Urban Area (도시 빈곤 노인의 낙상발생 위험요인에 관한 연구)

  • Choi, Kyung-Won;Lee, In-Sook
    • Journal of Korean Academy of Nursing
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    • v.40 no.4
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    • pp.589-598
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    • 2010
  • Purpose: The purpose of this study was to investigate the factors that increase of the risk for falls in low-income elders in urban areas. Methods: The participants were elderly people registered in one of public health centers in one city. Data were collected by interviewing the elders, assessing their environmental risk factors, and surveying relevant secondary data from the public health center records. For data analysis, descriptive statistics and multiple logistic regression were performed using SPSS version 14. Results: Stroke, diabetes, visual deficits, frequency of dizziness, use of assistive devices and moderate depression were statistically significant risk factors. The comorbidity of chronic diseases with other factors including depression, visual deficit, dizziness, and use of assistive devices significantly increased the risk of falls. From multiple logistic regression analysis, statistically significant predictors of falls were found to be stroke, total environmental risk scores, comorbiditiy of diabetes with visual deficits, and with depression. Conclusion: Fall prevention interventions should be multifactorial, especially for the elders with stroke or diabetes, who were identified in this study as the high risk group for falls. A fall risk assessment tool for low-income elders should include both the intrinsic factors like depression, dizziness, and use of assistive devices, and the extrinsic factors.

Suggestion of a Check List to Prevent Fall Incidents Through Case Analysis of Electric Shutters in Buildings (건축물 전동셔터 사례 분석을 통한 추락방지 체크리스트 제안)

  • Jung, Young-Min;Bang, Hong-Soon;Kim, Ok-Kyue
    • Journal of the Korea Institute of Building Construction
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    • v.22 no.3
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    • pp.259-268
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    • 2022
  • Electric shutters for buildings are being developed in Korea and abroad on a regular basis and can be used in different types of buildings such as company buildings and fire stations, etc. However, the fall risk factors induced by a variety of functions of building electric shutters require safety control. We reviewed the technological trends and legal standards in Korea and abroad, analyzed incident cases, and identified fall risk factors requiring control. We inspected all the building electric shutters in Korea based on the fall risk factors. As a result, we identified 91 noncompliance cases, in 69 percent of all 132 locations. In this study, backed by the inspection results, we suggest a check list to prevent the fall of building electric shutters to ensure safety and conduct verification using a focus group interview.

Effect of trunk training in wheelchair on fall efficacy, fall risk, activities of daily living in acute stroke patients: Randomized controlled pilot study (휠체어 몸통 훈련이 급성기 뇌졸중 환자의 낙상 효능감, 낙상 위험도, 일상생활활동에 미치는 영향: 무작위 대조군 예비 연구)

  • Jung, Kyeoung-Man;Jung, Yu-Jin
    • Journal of Korean Physical Therapy Science
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    • v.29 no.3
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    • pp.1-11
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    • 2022
  • Background: The aim of this randomized controlled pilot study was to determine the effect of trunk training in wheelchair on fall efficacy, fall risk and activities of daily living in acute stroke patients. Design: Randomized controlled pilot trial. Methods: The study included 18 patients with acute stroke who were randomly allocated to an experimental group (EG) (n=9) and a control group (CG) (n=9). Patients in the EG group received general rehabilitation therapy combined with trunk training in wheelchair for 20min, whereas CG group received general rehabilitation therapy combined with bicycle training for 20min. Both groups performed the exercise 5 times a week for 3 weeks. Outcomes were assessed using Korean-Fall Efficacy Scale (K-FES), Fullerton Advanced Balance Scale (FAB) and Korean-Modified Barthel Index (K-MBI). Results: After 3 weeks of training, both groups showed significantly improved K-FES, FAB and K-MBI (p<.05 in both groups). However, the K-FES, FAB and K-MBI in the experimental group was significantly improving than in the control group (p<.05). Conclusion: These findings indicate that trunk training in wheelchair may be effective at decreasing fall risk and improving activities of daily living in acute stroke patients. Therefore, trunk training in wheelchair may be recommended as an intervention in reducing the incidence of fall risk in acute stroke patient.

Characteristics of Fall Events and Fall Risk Factors among Inpatients in General Hospitals in Korea (입원 환자의 낙상실태 및 위험요인 조사연구: 국내 500병상 이상 종합병원을 중심으로)

  • Choi, Eun Hee;Ko, Mi Suk;Yoo, Cheong Suk;Kim, Mi Kyoung
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.3
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    • pp.350-360
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    • 2017
  • Purpose: The purpose of this study was to investigate the present status of falls among inpatients in general hospitals and to identify the fall risk factors that reflect the characteristics of domestic hospitals. Methods: Data were collected between December 15, 2016 and January 15, 2017 from 32 Korean hospitals having 500 or more beds. First, 42 risk factors were extracted based on literature review and expert opinions. Then the importance of each factor was evaluated by 223 nurses from medical and surgical adult ward and intensive care units in 40 hospitals. Results: The incidence rate of falls in 18 hospitals was 3.87 per 1,000 total discharged patients and 0.55 per 1,000 patient-days, and the rate of injury-related falls was 40.5%. Major risk factors for falling were identified as the following: being over 65 years of age, history of falls during admission, physical mobility disorders requiring assistance, physical factors (dizziness or vertigo, unstable gait, general weakness, walking aids, visual problems), cognitive factors (delirium, lack of understanding on limitations), neurological disease, CNS medications Conclusion: The findings provide information that can be in the development of a fall risk assessment tool for inpatients in general hospitals in Korea.

A Literature Review of Exercise Intervention for Fall Prevention in the Elderly (고령자의 낙상예방을 위한 운동처방에 대한 고찰)

  • Kim, Mi-Sook;Lee, Eun-Nam
    • Journal of muscle and joint health
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    • v.13 no.1
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    • pp.7-19
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    • 2006
  • Falls are a major sources of death and injury in elderly people. Aged-related changes in the physiological systems which contribute to the maintenance of balance are well documented in older adults. These changes coupled with age-related changes in muscle and bone are likely to contribute to an increased risk of falls in this population. Regular exercise may be one way of preventing falls and fall-related fractures. However, the optimal exercise prescription to prevent falls has not yet been defined. On the literature review of exercise intervention for fall prevention in the elderly, exercise appeared to be a useful tool in fall prevention by improving fall risk factors. The optimum exercise prescription; moderate intensity frequency of 3-4 times per week, duration of 30-60minutes can contribute to decreased hazards and number of fall. Fall prevention protocol should include safety, falling effect, enjoyment, and easiness to follow for older people. Effective exercise programs suggested for fall prevention were such as weight-bearing exercise, resistance exercise, lower muscle strength with elastic band, swiss ball exercise walking, tai chi, and yoga.

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A Literature Review for Fall-Prevention Nursing Program Development based on the Fall Information of a Rehabilitation Hospital (일 지역 재활병원의 낙상 정보에 근거한 낙상예방 간호중재 프로그램 개발을 위한 문헌분석 연구)

  • Park, Hee-Ok;Kang, Hee-Kyung
    • Journal of Convergence for Information Technology
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    • v.10 no.8
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    • pp.99-107
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    • 2020
  • This study is to design an effective fall-prevention nursing program. Researchers investigated the current condition and risk factors for falls in the small-medium sized rehabilitation hospital with descriptive research. We conducted integrative literature review to reflect the current approach of fall-prevention nursing program. We found that the risk factors for falls are related to the characteristics of clinical setting of the hospital. We suggested the nursing intervention with applying fall risk assessment scale that is sensitive to the elderly population and the intervention that shows maximum effect. In conclusion, this study proposed the way of selecting an effective fall-prevention nursing program based on a clinical setting and prospective of its application. This will contribute to the improvement in nursing practice with the critical view in hospital fall.