• Quality Improvement in Health Care
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• v.24 no.2
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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.

• Journal of Korean Academy of Nursing
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• v.41 no.1
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• pp.119-128
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• 2011

Purpose: This study was done to determine the risk factors for recurrent fallers (2+falls) compared to single fallers. Methods: Participants were 104 community-dwelling people 65 yr of age or older. The data were collected from June 1, 2008 to June 30, 2009 using the Residential Assessment Instrument-Home Care. Results: Over the past 90 days, 55.7% of the 104 participants fell once, and 44.2% experienced recurrent falls (2+falls). In comparison of recurrent fallers with single fallers, there were significant differences in scores on the following factors: gender ($X^2$=4.22, p=.040), age ($X^2$=5.74, p=.017), educational level ($X^2$=5.22, p=.022), living arrangements ($X^2$=35.02, p<.001), cardiovascular diseases ($X^2$=17.10, p<.001), hypertension ($X^2$=4.43, p=.035), diabetes mellitus ($X^2$=4.44, p=.035), glaucoma ($X^2$=13.95, p<.001), Minimal Data Set (MDS)-Pain (t=-2.56, p=.012), fear of falling ($X^2$=4.08, p=.034), reduced vision (t=-3.06, p=.003), MDS-activity of daily living (t=3.46, p=.001), MDS-Instrumental Activities of daily living (t=3.24, p=.002), cognition (MDS-Cognition Performance Scale) (t=3.40, p=.001), and 'difficulties entering and leaving the house' ($X^2$=4.53, p=.033). Conclusion: It is important to assess the risk factors for recurrent falls and develop differentiated strategies that will help prevent recurrent falls. Additionally, utilizing a standardized tool, such as RAI-HC, would help health professionals assess multi-variate fall risk factors to facilitate comparisons of different community care settings.

• Journal of Korean Academy of Nursing
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• v.34 no.8
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• pp.1483-1490
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• 2004

Community-based centres were surveyed to determine the frequency of and risk factors for falls among elderly Koreans. We examined fall-related risk factors, including physiological and physical health, psychosocial functions, self-reported physical capacity and activity, vision, and the use of medication, among 351 elderly people aged 65 years or older, with ambulatory. Forty-two per cent of elderly Korean subjects reported at least one episode of falling in the previous 12 months, $38\%$ of whom had consequences that required either the attention of a physician or hospitalization. Factors significantly associated with an increased risk of falling were a restricted activity during the previous five years (adjusted OR 1.3), use of alternative therapy (adjusted OR 2.7), low knee flexor and extensor-muscle strength (adjusted OR 1.21 and 1.20), and poor balance with closed eyes (adjusted OR 8.32). We conclude that falls among older persons living in the community are common in Korea and that indicator of bad health and frailty or variables directly related to neuromuscular impairment are significant predictors of the risk of falling.

• 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.

• Proceeding of Spring/Autumn Annual Conference of KHA
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• 2000.11b
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• pp.131-136
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• 2000

The purpose of this study is to identify the perceptual differences among independent elderly relative. to falls risk associated with specified environmental design factors. The sample consisted of 135 independent elderly who live in Ulsan. The data were collected by utilizing questionnaire which included demographic information, and environmental design assessments accompanied by line drawings. The data were analyzed by using SAS program. The major findings were as follows: (1) There were 35(25.9％) elderly experienced fall(s) within one year and about half of the fallers fell more than once. (2) The elderly perceived lighting is the most hazardous interior design factor related to increased risk of falls. (3) There was a significant difference among age groups on perception of lighting as interior design factors and the elderly perceived differently floor as interior design factors by their perceived health status.

• Korean Institute of Interior Design Journal
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• no.25
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• pp.130-134
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• 2000

The purpose of this study is to identify the perceptual differences among independent elderly relative to falls risk associated with specified environmental design factors. The sample consisted of 135 independent elderly who live in Ulsan. The data were collected by utilizing questionnaire which included demographic information, and environmental design assessments accompanied by line drawings. The data were analyzed by using SAS program. The major findings were as follows: (1) There were 35(25.9%) elderly experienced fall(s) within one year and about half of the fallers fell more than once. (2) The elderly perceived lighting is the most hazardous interior design factor related to increased risk of falls. (3) There was a significant difference among age groups on perception of lighting factors and the elderly perceived floor factors differently by their perceived health status.

• 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.

• Journal of Home Health Care Nursing
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• v.24 no.1
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• pp.34-43
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• 2017

Purpose: The purpose of this study was to provide basic data to develop a Fall Prevention Education Program by comparing and analyzing fall experiences and the factors that influence elderly people with dementia suffering falls. Methods: The participants were 302 patients with dementia aged 60 years or older with nursing records of hospitalization in three nursing homes located in a metropolitan area. The SPSS/Win 21.0 package was used to analyze the collected data. A logistic regression analysis was performed to identify the influence factors related to fall experiences. Results: For men, fall experiences were more frequent given the following factors: overweight; high fall risk tendency; aged 90 and above; married; dementia duration period of 5 to 9 years; and taking medication for dementia. For women, the factors included age range of 80 to 89; overweight; obese; both low and high fall risk tendency; separation by death; and having spent less than 1 year in nursing homes. Conclusion: We anticipate positive results in fall prevention education programs for the elderly with dementia if the results of this study are used as basic data, and interventions are customized to consider the sex and the relevant influence factors as to fall experiences.

• 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.

• 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.