• 한국의료질향상학회지
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• 제24권2호
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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.

• 한국의료질향상학회지
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• 제24권2호
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• pp.41-61
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• 2018

Purpose: Falls are one of the most frequent health events in medical institutions, however, they can be predicted and prevented. The Quality Improvement Nurse Society clinical practice guideline Steering Committee developed the Clinical Practice Guideline for the assessment and prevention of falls in adult people. The purpose of this study was to assess the risk factors for falls in adults aged 19 years and older, to present an evidence for preventing falls, formulate a recommendations, and indicators for applying the recommendations. Methods: This clinical practice guideline was developed using a 23-step adaptation method according to the Handbook for clinical practice guideline developer (version 1.0) by National Evidence-based Healthcare Collaborating Agency. Evidence levels and recommendation ratings were established in accordance to SIGN 2011 (The Scottish Intercollegiate Guidelines Network). Results: The final 15 recommendations from four domains were derived from experts' advice; 1) assessment of risk factor for falls in adult 2) preventing falls and reducing the risks of falls or falls-related injury 3) management and reassessment after a person falls 4) leadership and culture. Conclusion: This clinical practice guideline can be used as a basis for evaluation and prevention of fall risk factors for adults, to formulate recommendations for fall risk assessment and fall prevention, and to present monitoring indicators for applying the recommendations.

• 보건교육건강증진학회지
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• 제24권4호
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• pp.23-39
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• 2007

Objective: The objective of this study is to identify the risk factors for falls among the Korean elderly population. Methods: We analyzed the data on 167 persons of 65 years of age or older who have experienced falls drawn from the Third Korea National Health and Nutrition Examination Survey. We conducted a cross-tabulation analysis and logistic regression analysis of the impact of the socio-demographic characteristics, health-related behavior, mobility, and morbidity upon the frequencies of falls. Results: Among the socio-demographic characteristics, gender(p<0.001), marital status(p<0.1), and the type of medical insurance(<0.1) were found to be statistically significant, Among the constraints on mobility, the severity of walking problems, (p<0.001) and depression(p<0.05) proved to be significant, As for variables related to health-related behavior, the level of routine physical activities (p<0.001) was found significant, Finally, rheumatism(p<0.1), osteoporosis(p<0.05), diabetes(p<0.1), urinary incontinence(p<0.01) were also significant. A logistic regression analysis of the incidence of falls revealed that urinary incontinence was the most important risk factor with an odds ratio of 2.7. Conclusion: Although a variety of factors affect the frequencies of falls in the elderly population, urinary incontinence proved to be the single most important risk factor. This finding implies that education for fall prevention is crucial for those with urinary incontinence.

• 기본간호학회지
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• 제26권1호
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• pp.1-11
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• 2019

Purpose: The goal was to use electronic health records to identify factors and outcomes associated with falls among patients admitted to hematology units. Methods: This retrospective case-control study included data from a tertiary university hospital. Analysis was done of records from 117 patients with a history of falls and 201 patients with no history of falls who were admitted to the hematology unit from January 1, 2013 to December 31, 2014. Risk factors were analyzed using hierarchical logistic regression; patient outcomes were analyzed using multiple logistic regression, Cox proportional hazards regression, and multiple linear regression. Results: Clinical factors such as self-care nursing (OR=4.47, CI=1.64~12.11), leukopenia (OR=6.03; CI=2.51~14.50), and hypoalbuminemia (OR=2.79, CI=1.31~5.96); treatment factors such as use of narcotics (OR=2.06, CI=1.01~4.19), antipsychotics (OR=3.05, CI=1.20~7.75), and steroids (OR=4.51, CI=1.92~10.58); and patient factors such as low education (OR=3.16, CI=1.44~6.94) were significant risk factors. Falls were also associated with increased length of hospital stay to 21.58 days (p<.001), and healthcare costs of 17,052,784 Won (p<.001). Conclusion: These findings can be a resource for fall prevention education and to help develop fall risk assessment tools for adults admitted to hematology units.

• 근관절건강학회지
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• 제21권1호
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• pp.36-45
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• 2014

Purpose: The purpose of this study was to investigate the factors increasing fall risk in the residential environment risk and the perceived fall risk among the older adults who received home care services to provide information for developing a comprehensive falls intervention program. Methods: The subjects were 227 community-dwelling elderly aged 65 years and over who were taken care of by home-visiting nurses of the national health centers. The data were collected from July to August in 2012 using the Choi's residential environmental risk scale (2010) and the Hong's fall risk scale (2011). Results: Requires an assistive devices to walk, modified residential environment, health security, approval certificate of LTC, residential safety perception, residential environment risk, and perception of fall risk were statistically significant risk factors. A multiple logistic regression analysis showed that room & kitchen, physical perception, medication & ADL perception, floor-related environmental perception, and daily living tool-related perception were statistically significant predictors of fall. Conclusion: The results showed that the residential environment and the perceived fall risk were associated with fall experiences among the elderly. It is necessary to develope multifactorial intervention programs considering both environmental and perceived risk factors as well as physical risk factors to reduce and prevent falls among the elderly.

• The Journal of Korean Physical Therapy
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• 제20권3호
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• pp.19-28
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• 2008

Purpose: We analyzed the incidence of falls and the related factors, circumstances, and consequences associated with falls in stroke patients. Methods: We recruited 127 stroke patients and used a self-reported questionnaire to measure fall prevalence rates and the related factors, circumstances, and consequences of falls. The chi-square test was used to establish associations between related factors. Results: The prevalence of falls in stroke patients was 69.3%, and was associated with gender and time since the stroke. Falls occurred 2-5 times (55.4%) poststroke and most subjects first fall in the 2$\sim$6 month (46.5%) after the stroke. Most (55%) falls occurred at the hospital. Walking was the most frequent circumstance for falls (38.5%). Most (54.4%) falls led to consequences such as fractures, ligament strains, bruises, or abrasions. Conclusion: Fall-prevention strategies decrease the number of falls and the severity of fall-related injuries. These data support the concept of preventive strategies for falls in stroke patients who are at risk.

• 한국전문물리치료학회지
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• 제13권4호
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• pp.16-22
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• 2006

Falling is a serious problem associated with aging. Unintentional injury, which most often results from falling, is one of the leading causes of death in elderly people. The purpose of this study is to investigate the risk factors of falls and to compare characteristics of people who fall with that of non-fallers among the rural community-dwelling elderly of Korea. A sample of 201 people, living in the community, aged 60 years and over was taken from the members of a center for seniors located in Jecheon city. The mean age of the participants was 70.5 years of age. The participants are comprised of 151 women and 50 men. Eighty four of the 201 participants (41.8%) fell during the previous year. Twenty two of the fallers (26.2%) fell down more than two times. It was found that fallers had poorer eyesight, multiple chronic diseases and a more difficult time walking than non-fallers. In the logistic regression analysis of falls, only the difficulty of walking one kilometer (OR=2.4) and chronic diseases (OR=2.5) have shown an increased risk of falls. The risk of recurrent falls is, in addition, influenced by the difficulty of walking one kilometer. The result of our study shows that the impairment of mobility was the strongest risk factor of recurrent falling.

• 지역사회간호학회지
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• 제12권3호
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• pp.600-608
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• 2001

Accidents are the fourth-leading causal factor of death among the elderly, and fall is a major type of accident (53.17%). Many cases of falls in the elderly result in delayed discovery and loss of quality of life. As the number of the elderly grows, falls will be a more important health problem. Most previous research on falls investigated prevalence. mortality, and the related factors. There are many studies proving the effect of rhythmic movements. But few researches considered linking risk factors of fall with rhythmic movements. Purpose: We want to show the changes after performing rhythmic movement program, in risk factors of falls and mobility such as flexibility, balance, muscle power and persistency in the elderly, in order to provide basic information needed for the development of fall injury prevention program for the elderly. Method: The design of this study is quasi-experimental, the equivalent control group, pretest-posttest. The subjects consist of 124 people who lived in Do-Bong-Qu. Seoul, agreed to participate in this study, and were able to follow this rhythmic movement program. About 93 % of them are from 65 to 84 years (Mean${\pm}$sd: $73.7{\pm}5.7$): 64% are female. The rhythmic movement program was designed. and performed by two community health nurses working in the Do-Bong-Gu Public Health Center, regularly twice a week from May, 4 to December, 17. in 10 senior citizens' community centers. Risk factors of fall were measured with RAFS- II (Risk Assessment for Falls Scale II) by asking about each item: mobility was measured by observing their specific movements asked by investigators. Results: 1. After performing the program during 7 months, risk factors score of falls were decreased significantly (paired-t = 4.77. p<0.01). 2. After performing the program during 7 months, flexibility (paired-t = 2.26. p=0.03) and mobility were improved (paired-t = 4.98. p<0.01). but muscle power and persistency did not change (paired-t = 0.33. p=0.74). Overall, mobility affecting the occurrence of falls was improved significantly (paired-t = 5.15. p<0.01). Conclusions: A regular rhythmic movement program can be helpful in preventing falls in the elderly. Further. we can develop a fall injury prevention program using rhythmic movement.

• Perspectives in Nursing Science
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• 제5권1호
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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.

• 임상간호연구
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• 제21권2호
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• pp.252-265
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• 2015

Purpose: This study examined the circumstances, risk factors, and the predictors of fall incidents among patients in the small and medium-sized hospitals. Methods: Fifty patients with any fall experiences were matched by gender, age, and medical departments with 100 patients without fall incident at the same hospital. Data were collected from 5 small and medium-sized hospitals. Data were analyzed using descriptive statistics, a Chi-square test, a Fisher's exact test, and a logistic regression with the SPSS/WIN 21.0 program. Results: In the patients with falls, the largest number of falls occurred during the day shift, in the patients' rooms, and while they were walking. Further 74.0% of the patients had physical injuries, and 34.0% had to take further medical diagnostic tests. Significant differences were found between the patients with falls and the others on 14 variables (cardiovascular disease, anemia, sedative-hypnotics, vasodilators, narcotic analgesics, dizziness, general weakness, unstable gait, walking aids, anger, anxiety, depression, orientation, and fear of fall). Narcotic analgesic use, dizziness, walking aids, and cardiovascular disease were identified as the predictors of fall incidents. Conclusion: These findings are hoped to be used in developing a fall risk assessment tool and fall prevention nursing programs for small and medium-sized hospitals.