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Characteristics and Risk Factors for Falls in Tertiary Hospital Inpatients

일개 종합병원 입원환자의 낙상관련 특성 및 낙상발생 예측요인

  • Received : 2017.01.06
  • Accepted : 2017.05.22
  • Published : 2017.06.30

Abstract

Purpose: The aim of this study was to explore characteristics of and risk factors for accidental inpatient falls. Methods: Participants were classified as fallers or non-fallers based on the fall history of inpatients in a tertiary hospital in Seoul between June 2014 and May 2015. Data on falls were obtained from the fall report forms and data on risk factors were obtained from the electronic nursing records. Characteristics of fallers and non-fallers were analyzed using descriptive statistics. Risk factors for falls were identified using univariate analyses and logistic regression analysis. Results: Average length of stay prior to the fall was 21.52 days and average age of fallers was 61.37 years. Most falls occurred during the night shifts and in the bedroom and were due to sudden leg weakness during ambulation. It was found that gender, BMI, physical problems such elimination, gait, vision and hearing and medications such as sleeping pills, antiarrhythmics, vasodilators, and muscle relaxant were statistically significant factors affecting falls. Conclusion: The findings show that there are significant risk factors such as BMI and history of surgery which are not part of fall assessment tools. There are also items on fall assessment tools which are not found to be significant such as mental status, emotional unstability, dizziness, and impairment of urination. Therefore, these various risk factors should be examined in the fall risk assessments and these risk factors should be considered in the development of fall assessment tools.

Keywords

References

  1. Hayes N. Prevention of falls among older patients in the hospital environment. British Journal of Nursing. 2004;13(15):896-901. http://dx.doi.org/10.12968/bjon.2004.13.15.15525
  2. National Patient Safety Agency. Slips, trips and falls in hospital [Internet]. London, UK: Author; 2007 [cited 2017 January 1]. Available from: http://www.npsa.nhs.uk.
  3. Kim YS, Choi-Kwon S. Fall risk factors and fall risk assessment of inpatients. Korean Journal of Adult Nursing. 2013;25(1):74-82. http://dx.doi.org/10.7475/kjan.2013.25.1.74
  4. Currie L. Fall and Injury prevention. In: Hughes RG, editor. Patient safety and quality: An evidence-based handbook for nurses. Rockville, MD: Agency for Healthcare Research and Quality; 2008.
  5. Smith IJ, editor. Reducing the risk of falls in your health care organization. Terrace, IL: Joint Commission Resources; 2005.
  6. Kim CG, Suh MJ. An analysis of fall incidence rate and its related factors of fall in inpatients. Quality Improvement in Health Care. 2002;9(2):210-228.
  7. Browne JA, Covington BG, Davila Y. Using information technology to assist in redesign of a fall prevention program. Journal of Nursing Care Quality. 2004;19(3):218-225. https://doi.org/10.1097/00001786-200407000-00008
  8. Oliver D, Daly F, Martin FC, McMurdo ME. Risk factors and risk assessment tools for falls in hospital in-patients: A systematic review. Age and Ageing. 2004;33(2):122-130. http://dx.doi.org/10.1093/ageing/afh017
  9. Vassallo M, Stockdale R, Sharma JC, Briggs R, Allen S. A comparative study of the use of four fall risk assessment tools on acute medical wards. Journal of the American Geriatrics Society. 2005;53(6):1034-1038. http://dx.doi.org/10.1111/j.1532-5415.2005.53316.x
  10. Morse JM, Morse RM, Tylko SJ. Development of a scale to identify the fall-prone patient. Canadian Journal on Aging. 2010;8(4):366-377. http://dx.doi.org/10.1017/S0714980800008576
  11. Morse JM. Preventing patient falls. Thousand Oaks, CA: Sage Publications; 2009.
  12. Kim SR, Yoo SH, Shin YS, Jeon JY, Kim JY, Kang SJ, et al. Comparison of the reliability and validity of fall risk assessment tools in patients with acute neurological disorders. Korean Journal of Adult Nursing. 2013;25(1):24-32. http://dx.doi.org/10.7475/kjan.2013.25.1.24
  13. Jang IS, Lee SG. Fall risk factors and characteristics of an acute hospital setting across clinical departments. Journal of Korean Academy of Fundamentals of Nursing. 2014;21(3):264-274. http://dx.doi.org/10.7739/jkafn.2014.21.3.264
  14. DiBardino D, Cohen ER, Didwania A. Meta-analysis: Multidisciplinary fall prevention strategies in the acute care inpatient population. Journal of Hospital Medicine. 2012;7(6):497-503. http://dx.doi.org/10.1002/jhm.1917
  15. Miake-Lye IM, Hempel S, Ganz DA, Shekelle PG. Inpatient fall prevention programs as a patient safety strategy: A systematic review. Annals of Internal Medicine. 2013;158(5 Pt 2):390-396. http://dx.doi.org/10.7326/0003-4819-158-5-201303051-00005
  16. Gu MO, Jeon MY, Kim HJ, Eun Y. A review of exercise interventions for fall prevention in the elderly. Journal of Korean Academy of Nursing. 2005;35(6):1101-1112. http://dx.doi.org/10.4040/jkan.2005.35.6.1101
  17. Baeck YJ. Fall risk at the emergency department in patient [master's thesis]. Busan: Pusan National University; 2011. p. 1-65.
  18. Kim KS, Kim JA, Choi YK, Kim YJ, Park MH, Kim HY, et al. A comparative study on the validity of fall risk assessment scales in Korean hospitals. Asian Nursing Research. 2011;5(1):28-37. https://doi.org/10.1016/S1976-1317(11)60011-X
  19. Park IS, Cho I, Kim EM, Kim MK. Evaluation of a fall risk assessment tool to establish continuous quality improvement process for inpatients' falls. Journal of Korean Academy of Nursing Administration. 2011;17(4):484-492. http://dx.doi.org/10.11111/jkana.2011.17.4.484
  20. Yang HM, Chun BC. Falls in the general hospital inpatients: Incidence, associated factors. Journal of Korean Society of Quality Assurance in Health Care. 2009;15(2):107-120.
  21. Lee YJ, Gu MO. Circumstances, risk factors, and the predictors of falls among patients in the small and medium-sized hospitals. Journal of Korean Clinical Nursing Research. 2015;21(2):252-265. http://dx.doi.org/10.22650/JKCNR.2015.21.2.252
  22. Kang YO, Song R. Identifying characteristics of fall episodes and fall-related risks of hospitalized patients. Journal of Muscle and Joint Health. 2015;22(3):149-159. http://dx.doi.org/10.5953/JMJH.2015.22.3.149
  23. Shin JG. Prevalence and management of falls among elderly in a hospital [master's thesis]. Seoul: Hanyang University; 2011. p.1-61.
  24. Sohng KY, Cho OH, Park MH. Medication use as a risk factor for falls among hospitalized stroke patients. Journal of Korean Academy of Nursing Administration. 2006;13(1):60-67.
  25. Walker PC, Alrawi A, Mitchell JF, Regal RE, Khanderia U. Medication use as a risk factor for falls among hospitalized elderly patients. American Journal of Health-System Pharmacy. 2005;62(23):2495-2499. http://dx.doi.org/10.2146/ajhp050116
  26. Gray-Micelli D. Preventing falls in acute care. In: Capezuti E, Zwicker D, Mezey M, Fulmer T, editors. Evidence-based geriatric nursing protocols for best practice. 3rd ed. New York, NY: Springer Publishing Company; 2008. p. 161-198.
  27. Sung YH, Kwon IG, Kim KH. Factors influencing falls in inpatients. Journal of Korean Academy of Fundamentals of Nursing. 2006;13(2):200-207.
  28. Kim EK, Lee JC, Eom MR. Falls risk factors of inpatients. Journal of Korean Academy of Nursing. 2008;38(5):676-684. http://dx.doi.org/10.4040/jkan.2008.38.5.676
  29. Hendrich AL, Bender PS, Nyhuis A. Validation of the Hendrich II fall risk model: A large concurrent case/control study of hospitalized patients. Applied Nursing Research. 2003;16(1):9-21. http://dx.doi.org/10.1053/apnr.2003.YAPNR2

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