• Quality Improvement in Health Care
• /
• v.15 no.2
• /
• pp.107-120
• /
• 2009

Background : To estimate fall incidence rate and associated factors in inpatients from a general hospital. Method : The data were collected from 104 fall incident reports developed by the patient safety committee in a general hospital in Seoul from 01 January 2007 to 31 December 2008. Information included general characteristics of patients, factors related to fall, types, places, circumstances and outcomes of fall. Result : The incidence rate of fall, which was 4.4 per 1,000 total discharged patients and 0.5 per 1,000 patient-days, was much lower than that of several hospitals in the United States. The difference may reflect the different incidence reporting system of each hospital. Fall-prone patients were, in general, $$\geq_-$$65 years of age, had an alert mental status, were ambulatory with some assistance, and were dependent on and ambulatory device. High incidence of falls was associated with patients with circulatory disease. The majority of fall events usually occurred in bed or at the bedside in the patient's room, and occurred more often during the night than during the day or evening. Risk factors of fall were use of drugs (antihypertensive or neuropsychiatric drugs) and environmental factors (e.g., overly high bed height, surrounding objects, inadequate fitness shoes and slippery floor). Physical injury occurred in 43.3% of fall events, which typically required diagnosis of injury and treatment such as suturing. Risk factors for repeated falls were use of a neuropsychiatric drug (odds ratio=13.9) and gait disturbance (odds ratio=91.2). Risk factors for fall-related injury were alert mental status (odds ratio=3.3 times more likely to fall than those who were drowsy or in a stupor) and general weakness(odds ratio=3.3 times more likely to fall than those who were not generally weak). Conclusion : Medical and nursing staff should be aware of the fall risk factors of hospitalized patients and should intensively pursue preventative strategies. Development of fall prevention education based on these results is recommended.

• 한국노년학
• /
• v.39 no.2
• /
• pp.231-240
• /
• 2019

The study aimed to identify risk factors for falls as well as hospitalization status according to disease and demographic characteristics of demented inpatients by investigating the in-depth Injury Patient Surveillance System data collected by Korea Centers for Disease Control and Prevention(KCDC). Older adults over 60 years old who were diagnosed with dementia were included(n=1,732). Their data were analyzed after being assigned to either a fall group or a non-fall group. STATA was used for statistical analyses, such as frequency analysis, chi-square (χ²) test, and logistics regression. It was found that 8.0% of the demented inpatients experienced falls. According to the analysis on category of fall and non-fall group were statistically significant difference in age and Charlson Comorbidity Index(CCI) and bone density deficiency. Based on the logistic regression analysis of factors affecting falls, older adults over 80 are 2.386 times more likely to fall and based on a target with a CCI of 0, the risk of falls is 0.421 times lower, finally based on those without bone density disorder, the fall risk for those with bone density disorder was 3.581 times higher. Therefore, we expect that the important about the factors relating to falls identified in this can not only be found valuable for educating inpatients with dementia and care-givers, but also be used as reference that supports clinical professionals to make decisions on falls management for patients with dementia.

• Proceedings of the Korean Institute of Building Construction Conference
• /
• 2018.11a
• /
• pp.63-64
• /
• 2018

The construction industry is one of the most prolific disaster-prone industries, particularly those that suffer from falling disasters compared to other industries. The safety accident at the construction site leads to social problems caused by massive loss of life and property, so it needs to be extra careful. The reason why falls are the most frequent accidents of the types of construction accidents is due to the analysis of the risk factors of safety accidents and the development of various construction methods. Therefore, in this study, the accident case for the fallen victims of construction site was analyzed and the risk factor was selected. Based on the safety expert survey, an importance analysis was performed. In conclusion, this study analyzes various risk factors that affect the occurrence of falls, identifies the importance of each factor, and presents basic data for safety accident prevention activities.

• Journal of Korean Clinical Nursing Research
• /
• v.28 no.3
• /
• pp.270-276
• /
• 2022

Purpose: The purpose of this study was to validate the Edmonson psychiatric fall risk assessment tool (EPFRAT) for psychiatric inpatients. Methods: Data from retrospective study were collected from 670 adult inpatients in two departments of mental health medicine of a tertiary general hospital by reviewing their electronic medical records. There were 41 patients who experienced falls and 629 patients who did not experience falls during the period from January to December 2019. Data were analyzed by sensitivity, specificity, positive predictive value, negative predictive value, and a receiver-operating characteristic curve (ROC) for validity assessment using the IBM SPSS/WIN 26.0 program. Results: Factors affecting falls were the participant's age, guardian's residence, high-risk determination at the time of admission, and comorbidity. At the 85 points where the point of sum of the sensitivity and specificity was largest, the sensitivity, specificity, positive predictive value, and negative predictive value of EPFRAT were 92.7%, 79.7%, 22.9%, and 99.4%, respectively. The area under the ROC to assess the overall validity of the tool was .92 (95% CI 0.89~0.94). Conclusion: The EPFRAT was proved to be valid and reasonable for predicting falls in psychiatric inpatients. Based on the results of this study, it could be used for the assessment of high-risk patients for falls in psychiatric units.

• Journal of muscle and joint health
• /
• v.11 no.1
• /
• pp.61-73
• /
• 2004

Purpose: The purpose of this study was to determine the effects of a 8- week Tai Chi exercise program on improving the risk factors for falls in the older adults with chronic arthritis pain. Method: Fifteen subjects were assigned for experimental group and thirteen were assigned for control group. The subjects of the experimental group participated in a 8 -week program of Tai Chi exercise. In order to evaluate the effects of Tai Chi program, pain intensity, postural stability, balance, gait, and flexibility of knees and ankles were measured before the first and after the 8th session Result: After a 8-week Tai Chi program, there were significant improvement in single-leg stance time with eyes open(left: p=.000, right: p=.003), total scores of balance(p=.004), total scores of gait(p=.005), and the angle of ankle dorsiflexion(p=.008) in the experimental group when compared to the control group. However, there was no significant difference in pain intensity between Tai Chi group and control group(p=.054). Conclusion: These results suggest that a 8-week Tai Chi exercise program can be utilized as a safe and effective nursing program to improve on improving the risk factors for falls in the older adults with osteoarthritis.

• Physical Therapy Korea
• /
• v.25 no.1
• /
• pp.39-46
• /
• 2018

Background: The Berg Balance Scale (BBS) and the Fullerton Advanced Balance (FAB) scale have been used to assess balance function in patients with chronic stroke. These clinical balance scales provide information about potential risk factors for falls. Objects: The purpose of this study was to investigate the incidence of and risk factors of falls and compare the predictive values of the BBS and FAB scale relative to fall risk in patients with stroke through receiver operating characteristic analysis. Methods: Sixty-three patients with stroke (faller=34, non-faller=29) who could walk independently for 10 meters participated in this study. The BBS and FAB scale were administered. Then, we verified the cut-off score, sensitivity, specificity, and the area of under the curve. Results: In this study, the BBS and FAB scale did not predict fall risk in patients with stroke in the receiver operator characteristic curve analysis. A cut-off score of 37.5 points provided sensitivity of .47 and specificity of .35 on the BBS, and a cut-off score of 20.5 points provided sensitivity of .44 and specificity of .45 on the FAB scale. Conclusion: The BBS and FAB scale were not useful screening tools for predicting fall risk in patients with stroke in this study, but those who scored 37.5 or lower on the BBS and 20.5 or lower on the FAB scale had a high risk for falls.

• Journal of muscle and joint health
• /
• v.18 no.1
• /
• pp.50-62
• /
• 2011

Purpose: The purpose of this study was to determine the incidence and influencing factors of falls in the institutionalized elderly. Method: A descriptive survey design was used with a convenience sampling of 430 institutionalized elderly. Data were collected using a structured questionnaire. Results: The falls rate after admission in institution was 8.4%. Types of injury after falls were mostly contusion and fracture. Interventions for fall prevention were environmental management and regular evaluation of risk factors for falls. Fall experience was significantly different according to admission periods. Type of falls was significantly different according to state of ADL. Predictors for falls were longer admission periods and dependent state in ADL. Conclusion: Falls is important health related problem in the institutionalized elderly, so effective fall prevention program is needed for their health promotion.

• Korea Journal of Hospital Management
• /
• v.26 no.4
• /
• pp.51-58
• /
• 2021

Purpose: This study is based on the results of previous studies that falls, which is a frequent social problem, causes physical, mental and social health problems in the elderly. In order to identify risk factors for falls in the elderly, this study derives a relationship with oral health and proposes the necessity of oral health care as part of countermeasures to prevent falls in the elderly. Methodology: The final 6,936 people were analysed using the 2018 Korean Longitudinal Study of Ageing(KLoSA) survey data, and the analysis was conducted using the multiple logistic and multiple regression analysis to investigate the relationship between Geriatric Oral Health Assessment Index (GOHAI) and falls experience. Findings: As a result of the analysis in this study, the number of falls experiences and whether or not falls were higher in the elderly female group than in the male group. The likelihood of falls experience has been statistically reduced as Geriatric Oral Health Assessment Index increases by one unit.(OR : 0.991) The number of falls has also been statistically reduced as Geriatric Oral Health Assessment Index increase by one unit.(B : -0.001) Practical Implications: The results of this study, which showed that higher Geriatric Oral Health Assessment Index was lower risk of falls, explained by the connection that oral health may affect nutritional intake, which leads to sarcopenia and physical loss, which in turn increases the risk of falls. As a way to solve the fall problem, efforts should be made to improve the oral health of the elderly, and furthermore, the importance of nutrition management thorugh oral health care of the elderly is increasd.

• Women's Health Nursing
• /
• v.18 no.4
• /
• pp.237-247
• /
• 2012

Purpose: The purpose of this study was to investigate the incidence of osteoporosis and falls and their consequences, and to identify predictors of fracture risk in the postmenopausal women. Methods: A total of 687 postmenopausal women were recruited through a stratified convenience sampling. A structured questionnaire was used to obtain osteoporosis and fall history and details of their most recent fall. To predict fracture risk factors, we collected demographic and physical health variables related osteoporosis and fall. Fracture risk was measured by FRAX$^{(R)}$ to calculate 10-year probability of major osteoporotic and hip fracture. Results: The prevalence of osteoporosis was 22.1%, and 66.4% of them had treatments for osteoporosis. The incidence of falls during the past year was 19.2% and 38.6% of those who fell suffered consequent fractures. Women with history of osteoporosis and falls were significant predictors of 10-year probability of major osteoporotic and hip fracture. Other significant predictors were history of fracture, chronic disease, surgical menopause, lower BMI, poorer perceived health and no job. Conclusion: It appears that history of osteoporosis and falls are main predictors of fracture risk. Nursing assessment should be performed by detail history taking for osteoporosis, fall, chronic disease, and fracture to screen fracture risk group among postmenopausal women.

• Journal of Korean Clinical Nursing Research
• /
• v.27 no.1
• /
• pp.77-84
• /
• 2021

Purpose: Malnutrition affects all age groups, but older adults are particularly more vulnerable to nutritional deficiencies. This study evaluated the age-specific factors affecting malnutrition in hospitalized older adults. Methods: A retrospective study was conducted on inpatient elderly people who received artificial nutrition from 2010 to 2017. Data of demographics, diagnosis, type of nutrition therapy, number of comorbidity, fall risk assessment, Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) score, and intensive care unit admission were collected. Malnutrition was defined as a body mass index (BMI) of less than 18.5 kg/m². Patients were classified as the young-old (65~74 years old), the old-old (75~84 years old), or the oldest-old (85 years old or older). Results: A total of 7,130 older adults were included, and 4,028 patients were classified as the young-old, 2,506 into the old-old, and 596 into the oldest-old. Proportion of malnutrition was higher in the oldest-old compared to the other groups. In multivariate analysis, parenteral nutrition, alcohol, and high risk of falls were factors affecting malnutrition in all groups. Parenteral nutrition and alcohol in the young-old, high risk of falls in the old-old, and male sex in the oldest-old were the factors affecting malnutrition by the age group. Conclusion: Older age was the most significant factor affecting malnutrition. Specific strategies by age are needed to improve nutritional status in hospitalized older adults as influencing factors for malnutrition vary among different age groups.