Korean Journal of Adult Nursing (성인간호학회지)

Korean Society of Adult Nursing (한국성인간호학회)
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Fall Risk Factors and Fall Risk Assessment of Inpatients

종합병원 입원 환자의 낙상 위험 요인 및 낙상 위험도 평가

  • Kim, Yoon Sook (Asan Medical Center) ;
  • ChoiKwon, Smi (College of Nursing, Research Institute of Nursing Science, Seoul National University)
  • Received : 2012.08.07
  • Accepted : 2013.02.21
  • Published : 2013.02.28
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Abstract

Purpose: The purpose of this study was to identify the fall risk factors and to evaluate the effectiveness of the Morse Fall Scale(MFS) as an assessment tool among hospitalized inpatients. Methods: The medical records of a total of 294 patients who admitted to hospital from January 1 to December 31, 2010 were reviewed. One hundred forth seven patients who had experienced fall were matched with 147 patients who have never experienced fall. The fall information was obtained from electronic medical records and fall reports. Results: There were significant differences in visual disturbances, pain, emotional disturbances, sleep disorder, urination problems and elimination disorder at admission between fallers and non-fallers. Patients who had higher MFS scores at admission were more likely to fall as compared to the patients with lower MFS scores. When falls did occur, these occurred within five days following admission, in the patient room, among patients with alert mental status, and among patients who were ambulant with some assistance. Conclusion: The findings of this study support the need of using risk assessment tool for predicting risk for falls. This finding can be used as a useful resource to develop nursing intervention strategies for fall prevention at the hospital.

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References

  1. American Nurses Association. (2011). NDNQI indicators and reported rates. Retrieved 2012, from the NDNQI Web site: https://www.nursingquality.org/data.aspx
  2. Beack, Y. J. (2011). Fall risk at the emergency department in patients. Unpublished master's thesis, Pusan National University, Busan.
  3. Browne, J. A., Covington, B. G., & Davila, Y. (2004). Using information technology to assist in redesign of a fall prevention program. Journal of Nursing Care Quality, 19(3), 218-225. https://doi.org/10.1097/00001786-200407000-00008
  4. Evans, D., Hodgkinson, B., Lambert, L., & Wood, J. (2001). Fall risk factors in the hospital setting: A systematic review. International Journal of Nursing Practice, 72 (4), 38-45.
  5. Foley, S. J., Lord, S. R., Srikanth, V., Cooley, H., & Jones, G. (2006). Falls risk is associated with pain and dysfunction but not radiographic osteoarthritis in older adults: Tasmanian older adult cohort study. Osteoarthritis Cartilage, 14 (6), 533-539. http://dx.doi.org/10.1016/j.joca.2005.12.007
  6. Grey-Miceli, D. (2008). Preventing falls in acute care. In E. Capezuti, D. Zwicker, M. Merzey, T. T., Fulmer, D., Gray- Miceli, & M. Kluger (ed.), Evidence-based geriatric nursing protocols for best practice (pp. 161-193). New York: Springer Publishing Company.
  7. Hayes, N. (2004). Prevention of falls among older patients in the hospital environment. British Journal of Nursing, 13 (15), 896-901. https://doi.org/10.12968/bjon.2004.13.15.15525
  8. Hur, J. Y., & Kim, H. J. (2009). Relationship of risk factors, knowledge and attitude to falls in elderly patients. Journal of Korean Gerontological Nursing, 11 (1), 38-50.
  9. Jung, D. Y., Lee, J. H., & Lee, S. M. (2009). A meta-analysis of fear of falling treatment programs for the elderly. Western Journal of Nursing Research, 31 (1), 6-16. https://doi.org/10.1177/0193945908320466
  10. Kim, C. G., & Suh, M. J. (2002). An analysis of fall incidence rate and its related factors of fall in inpatients. Journal of Korean Society of Quality Assurance in Health Care, 9 (2), 210-228.
  11. Kim, E. K., Lee, J. C., & Eom, M. R. (2008). Fall risk factors of inpatients. Journal of Korean Academic Nursing, 38(5), 676- 684. https://doi.org/10.4040/jkan.2008.38.5.676
  12. Kim, K. S., Kim, J. A., Choi, Y. K., Kim, Y. J., Park, M. H., Kim, H. Y., et al. (2011). A comparative study on the validity of fall risk assessment scales in Korean hospitals. Asian Nursing Research, 5, 28-37. https://doi.org/10.1016/S1976-1317(11)60011-X
  13. Lane, A. J. (1999). Evaluation of the fall prevention program in an acute care setting. Orthopedic Nursing, 18(6), 37-46.
  14. Leveille, S. G., Jones, R. N., Kiely, D. K., Hausdorff, J. M., Shmerling, R. H., Guralnik, J. M., et al. (2009). Chronic musculoskeletal pain and the occurrence of falls in an older population. Journal of the American Medical Association. 302(30), 2214-21. http://dx.doi.org/10.1001/jama.2009.1738
  15. Mayo, N. E., Korner-Bitensky, N., & Kaizer, F. (1990). Relationship between response time and falls among stroke patients undergoing physical rehabilitation. International Journal of Rehabilitation Research, 13(1), 47-55. https://doi.org/10.1097/00004356-199003000-00005
  16. Morse, J. M. (1997). Preventing patient falls. Thousand Oaks, CA: Sage.
  17. Morse, J. M., Morse, R. M., & Tylko, S. J. (1989). Development of a scale to identify the fall-prone patient. Canadian Journal on Aging, 8, 366-377. https://doi.org/10.1017/S0714980800008576
  18. National Patient Safety Agency. (2007). Slips, trips and falls in hospital. London: NPSA, 2007, Retrieved from http://www.npsa.nhs.uk
  19. Oliver, D., Britton, M., Seed, P., Martin, F.C., & Hopper, A. H. (1997). Development and evaluation of evidence based assessment tool (STRATIFY) to predict which elderly inpatients will fall: Case-control and cohort studies. British Medical Journal, 315, 1049-1053. http://dx.doi.org/10.1136/bmj.315.7115.1049
  20. Oliver, D., Daly, F., Martin, F. C., & McMurdo, E. T. (2004). Risk factors and risk assessment tools for falls in hospital in-patients: A systematic review. Age Ageing, 33 (2), 122-130. http://dx.doi.org/10.1093/ageing/afh017
  21. Park, I. S., Cho, I. S., Kim, E. M., & Kim, M. K. (2011). Evaluation of a fall risk assessment tool to establish continuous quality improvement process for inpatients falls. Journal of Korean Academy of Nursing Administration, 17 (4), 484-492. https://doi.org/10.11111/jkana.2011.17.4.484
  22. Poe, S. S., Cvach, M. M., Gartrell, D. G., Radizik, B. R., & Joy, T. L. (2005). An evidence-based approach to fall risk assessment, prevention and management lessons learned. Journal of Nursing Care Quality, 20 (2), 107-116. https://doi.org/10.1097/00001786-200504000-00004
  23. Sasakia, E. D., Niek, S. K., Patrick, S. R., Daniel, J. T., Maria, A. G., & Moria, C. H. (2009). Application of patient safety indicators internationally: A pilot study among seven countries. International Journal for Quality in Health Care, 21(4), 272-278. http://dx.doi.org/10.1093/intqhc/mzp018
  24. Schwendimann, R., DeGeest, S., & Milsen, K. (2006). Evaluation of the morse fall scale in hospitalized patients. Age Ageing, 35(5), 311-313. http://dx.doi.org/10.1093/ageing/afj066
  25. Scott. D., Blizzard, L., Fell, J., & Jones, G. (2010). A prospective study of self-reported pain, radiographic osteoarthritis, sarcopenia progression and falls risk in community-dwelling older adults. Arthritis Care Res, 64(1), 30-37. http://dx.doi. org/10.1002/acr.20545
  26. Shin, J. G. (2011). Prevalence and management of falls among elderly in a hospital. Unpublished master's thesis, Hanyang University, Seoul.
  27. Staab, A. S., & Hodges, L. C. (1996). Essentials of Gerontological Nursing, Philadelphia, PA: Lippincott Company.
  28. Tinetti, M. E., Speechley, M., & Ginter, S. F. (1988). Risk factors for falls among elderly persons living in the community. New England Journal of Medicine, 310, 1701-1707.
  29. Wong, C. A., Recktenwald, A. J., Jones, M. L., Waterman, B. M., Bollini, M. K., & Dunagan, W. C. (2011). The cost of serious fall-related Injuries at three midwestern hospitals. Joint Commission Journal on Quality and Patient Safety, 37 (2), 81-87. https://doi.org/10.1016/S1553-7250(11)37010-9
  30. Yoon, J. L. (2000). Fall. Journal of the Korean Geriatrics Society. 4(1), 53-63.

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