Journal of Korean Clinical Nursing Research (임상간호연구)

Hospital Nurses Association (병원간호사회)
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Factors Associated with Injuries after Inpatient Falls in a Tertiary Hospital

상급종합병원 입원환자의 낙상 후 상해 실태 및 상해에 영향을 미치는 요인

  • Received : 2017.05.30
  • Accepted : 2017.06.20
  • Published : 2017.08.31
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Abstract

Purpose: In this study an investigation was done of injuries from inpatient falls and diagnostic tests and treatment after falls to identify what factors affect the occurrence of injury from inpatient falls in a tertiary hospital. Methods: Data for this cross-sectional study were retrieved for 428 fall events from data reported between January 1 and December 31, 2015 and were retrieved from the patient-safety reporting system in the hospital's electronic health records. A multivariate logistic regression model was developed with STATA 13.0. Results: Of the patients, 197 (46.0%) had physical injuries due to falls, 119 (27.8%) were given further diagnostic tests, and 358 (83.6%) received treatment including close observation after inpatient falls. Logistic-regression results identified that age, department, and risk factors had significant impact on injuries from falls. Conclusion: Findings indicate that to reduce the severity of injury after inpatient falls, each hospital should regularly evaluate identified factors, design fall-prevention practices specialized for elders and vulnerable patients, and initiate environmental and equipment innovations.

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References

  1. Garrard L, Boyle DK, Simon M, Dunton N, Gajewski B. Reliability and validity of the NDNQIⓇ injury falls measure. Western Journal of Nursing Research. 2016;38(1):111-128. http://dx.doi.org/10.1177/0193945914542851
  2. Evans D, Hodgkinson B, Lambert L, Wood J. Falls risk factors in the hospital setting: A systematic review. International Journal of Nursing Practice. 2001;7(1):38-45. http://dx.doi.org/10.1046/j.1440-172x.2001.00269.x
  3. 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):9-12. https://doi.org/10.1053/apnr.2003.016009
  4. Oliver D, Healey F, Haines TP. Preventing falls and fall-related injuries in hospitals. Clinics in Geriatric Medicine. 2010; 26(4):645-692. http://dx.doi.org/10.1016/j.cger.2010.06.005
  5. Halm MA, Quigley PA. Reducing falls and fall-related injuries in acutely and critically ill patients. American Journal of Critical Care. 2011;20(6):480-484. http://dx.doi.org/10.4037/ajcc2011606
  6. Ruchinskas R. Clinical prediction of fall in the elderly. American Journal of Physical Medicine and Rehabilitation. 2003;82 (4):273-278. http://dx.doi.org/10.1097/01.phm.0000056990.35007.c8
  7. Tzeng HM, Yin CY. Nurses' solutions to prevent inpatient falls in hospital patient rooms. Nursing Economic$. 2008;26(3): 179-187.
  8. Healey F, Scobie S. Slips, trips and falls in hospital, London: National Patient Safety Agency [Internet]. London: National Patient Safety Agency; 2007[cited 2017 May 4]. Available from: http://www.nrls.npsa.nhs.uk/resources/?entryid45=59821.
  9. Wong CA, Recktenwald AJ, Jones ML, Waterman BM, Bollini ML, Dunagan WC. The cost of serious fall-related Injuries at three midwestern hospitals. The Joint Commission Journal on Quality and Patient Safety. 2011;37(2):81-87. http://dx.doi.org/10.1016/S1553-7250(11)37010-9
  10. Hwang JH, Jung HM, Lee MH, Lee SJ. Effects of fall prevention program on gait, balance and falls efficacy in stroke patients. Journal of Korean Clinical Nursing Research. 2010; 16(1):27-37.
  11. Korea Consumer Agency. Survey report on the types of safety events for the elderly: In-depth analysis of risk information [Internet]. Consumer Safety Agency, Risk Information Team, Seoul; 2010[cited 2017 May 1]. Available from: https://www.ciss.go.kr/www/selectBbsNttView.do?key=187&bbsNo=84&nttNo=3869&searchCtgry=&searchCnd=all&sea rchKrwd=&pageIndex=17&pageUnit=10&integrDeptCode=.
  12. Drösler SE, Klazinga NS, Romano PS, Tancre DJ, Gogorcena AM, Hewitt MC, et al. Application of patient safety indicators internationally: A pilot study among seven countries. International Journal for Quality in Health Care. 2009;21(4):272-278. https://doi.org/10.1093/intqhc/mzp018
  13. Currie LM, Mellino LV, Cimino JJ, Bakken S. Development and representation of a fall-injury risk assessment instrument in a clinical information system. Studies in Health Technology and Informatics. 2004;107(1):721-725.
  14. Bergland A, Wyller TB. Risk factors for serious fall related injury in elderly women living at home. Injury Prevention. 2004;10(5):308-313. http://dx.doi.org/10.1136/ip.2003.004721
  15. Kim SJ, Lee YM. Falls risk factors of elderly inpatients. Journal of the Korean Data Analysis Society. 2014;16(4):2191-2203.
  16. 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
  17. Lee YJ, Gu MO. Circumstances, risk factors, and the predictors of falls among patients in the small and medium-sized hospitals. Journal of the Korean Clinical Nursing Research. 2015;21(2):252-265. https://doi.org/10.22650/JKCNR.2015.21.2.252
  18. Hitcho EB, Krauss MJ, Birge S, Claiborne Dunagan W, Fischer I, Johnson S, et al. Characteristics and circumstances of falls in a hospital setting: A prospective analysis. Journal of General Internal Medicine. 2004;19(7):732-739. http://dx.doi.org/10.1111/j.1525-1497.2004.30387.x
  19. Krauss MJ, Nguyen SL, Dunagan WC, Birge S, Costantinou E, Johnson S, et al. Circumstances of patient falls and injuries in 9 hospitals in a midwestern healthcare system. Infection Control and Hospital Epidemiology. 2007;28(5):544-550. http://dx.doi.org/10.1086/513725
  20. Healey F. A guide on how to prevent falls and injury in hospitals. Nursing Older People. 2010;22(9):16-22. http://dx.doi.org/10.7748/nop2010.11.22.9.16.c8060
  21. Lee EJ, Kim CG. A survey of fractures and factor associated with falls in elderly patients. Journal of Korean Gerontological Nursing. 2003;5(2):182-192.
  22. Tinetti ME, Speechley M, Ginter SF. Risk factor for falls among elderly persons living in the community. The New England Journal of Medicine. 1988;319(26):1701-1707. http://dx.doi.org/10.1056/nejm198812293192604
  23. Kim EK, Lee JC, Eom MR. Falls risk factor of inpatients. Journal of Korean Academy of Nursing. 2008;38(5):676-684. http://dx.doi.org/10.4040/jkan.2008.38.5.676
  24. Montalvo I. The National Database of Nursing Quality Indicators TM(NDNQI$^{(R)}$). The Online Journal of Issues in Nursing. 2007;12(3). http://dx.doi.org/10.3912/OJIN.Vol12No03Man02
  25. Hwang SY, Shin SJ. Predictors of fall prevention behaviors in elderly inpatients. Korean Journal of Health Promotion. 2013; 13(2):76-85.
  26. 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