• Korean Journal of Adult Nursing
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• v.27 no.5
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• pp.559-571
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• 2015

Purpose: This study is to determine the predictive validity of the St. Thomas Risk Assessment Tool in Falling Elderly Inpatients (STRATIFY) for inpatients' fall risk. Methods: A literature search was performed to identify all studies published between 1946 and 2014 from periodicals indexed in Ovid Medline, Embase, CINAHL, KoreaMed, NDSL and other databases, using the following key words; 'fall', 'fall risk assessment', 'fall screening', 'mobility scale', and 'risk assessment tool'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Fourteen studies were analyzed using meta-analysis with MetaDisc 1.4. Results: The predictive validity of STRATIFY was as follows; pooled sensitivity .75 (95% CI: 0.72~0.78), pooled specificity .69 (95% CI: 0.69~0.70) respectively. In addition, the pooled sensitivity in the study that targets only the over 65 years of age was .89 (95% CI: 0.85~0.93). Conclusion: The STRATIFY's predictive validity for fall risk is at a moderate level. Although there is a limit to interpret the results for heterogeneity between the literature, STRATIFY is an appropriate tool to apply to hospitalized patients of the elderly at a potential risk of accidental fall in a hospital.

• Quality Improvement in Health Care
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• v.22 no.2
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• pp.27-40
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• 2016

Purpose: Globally, falls are a major public health problem. The study aimed to evaluate the predictive validity of the Timed Up and Go test (TUGT) as a screening tool for fall risk. Methods: An electronic search was performed Medline, EMBASE, CINAHL, Cochran Library, KoreaMed and the National Digital Science Library and other databases, using the following keywords: 'fall', 'fall risk assessment', 'fall screening', 'mobility scale', and 'risk assessment tool'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Thirteen studies were analyzed using meta-analysis with MetaDisc 1.4. Results: The selected 13 studies reporting predictive validity of TUGT of fall risks were meta-analyzed with a sample size of 1004 with high methodological quality. Overall predictive validity of TGUT was as follows. The pooled sensitivity 0.72 (95% confidence interval [CI]: 0.67-0.77), pooled specificity 0.58 (95% CI: 0.54-0.63) and sROC AUC was 0.75 respectively. Heterogeneity among studies was a moderate level in sensitivity. Conclusion: The TGUT's predictive validity for fall risk is at a moderate level. Although there is a limit to interpret the results for heterogeneity between the literature, TGUT is an appropriate tool to apply to all patients at a potential risk of accidental fall in a hospital or long-term care facility.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.21 no.3
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• pp.264-274
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• 2014

Purpose: This study was done to determine inpatient fall rates in an acute hospital setting and to explore risk factors and characteristics across clinical departments. Methods: The medical records and standardized fall reports of 416 patients admitted between January 1 and December 31, 2012 were reviewed. Descriptive statistics and statistical tests were used, including: t-test, ${\chi}^2$-test, ANOVA. Results: The total fall rate per 1,000 inpatient days was 0.49. Fall rate, fall risk factors and characteristics such as age, type of fallers and mean MFS (Morse Fall Scale) differed significantly among clinical departments. Conclusions: The analysis results show that the fall rates, fall risk factors and characteristics of acute hospital inpatient falls varied significantly across clinical departments. The findings of this study suggest that hospitals should consider differences in fall related characteristics across clinical departments when implementation fall prevention strategies and interventions.

• Journal of Korean Academy of Nursing
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• v.47 no.3
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• pp.420-430
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• 2017

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.

• Journal of muscle and joint health
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• v.26 no.2
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• pp.63-71
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• 2019

Purpose: This descriptive study investigated the mediating and moderating effects of fear of fall on the relationships between health belief on fall, fall-related knowledge and fall prevention behaviors among older adults Methods: We enrolled 229 older adults residing in a senior citizen hall and community welfare center, and investigated their health belief on fall, fall-related knowledge, fall prevention behavior, and fear of fall. Descriptive statistics, ANOVA and t-test were used to analyze differences in variables. Pearson correlation and multiple regression were used to investigate mediating and moderating effects of the fear of fall on the relationships between health belief on fall, fall-related knowledge, and fall prevention behaviors. Results: The fear of fall significantly mediated the health belief on fall and fall prevention behaviors, but there was no significant mediation between knowledge of fall and fall prevention behaviors. The fear of fall did not have a moderating effect on the relationships between health belief on fall, knowledge of fall, and fall prevention behaviors. Conclusion: It is important to investigate and implement health belief on fall and fear of fall among older adults to improve their fall prevention behaviors.

• The Korean Journal of Health Service Management
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• v.12 no.4
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• pp.155-172
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• 2018

Objectives: The purpose of this study was to investigate the influence of fall-related knowledge and fall prevention self-efficacy of care-givers working in long-term care hospitals on fall prevention behaviors and fall management behaviors for older adults with dementia. Methods: Participants were 125 care-givers working in long-term care hospitals. Data were collected with structured questionnaires from August 7 to 14, 2018. Data were analyzed by t-test, ANOVA, $Scheff{\dot{e}}$ test, Pearson's correlation coefficients, and multiple regression analysis using SPSS 18.0. Results: Fall prevention self-efficacy influence fall prevention behaviors(${\beta}=.55$, p<.001), while fall-related knowledge impacted fall management behaviors(${\beta}=.43$, p<.001). Conclusions: The results suggest that an education program for fall prevention of older adults with dementia in long-term care hospitals should focus on improving the fall-related knowledge and fall prevention self-efficacy of care-givers to increase both the fall prevention behaviors and fall management behaviors of care-givers.

• Journal of Korean Clinical Nursing Research
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• v.29 no.1
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• pp.56-66
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• 2023

Purpose: This study aimed to investigate whether the comprehensive nursing care service positively affected accidental falls and pressure injuries. Methods: This study was a retrospective study that analyzed the accidental falls and pressure injuries cases in an acute care hospital located in Seoul and compared the rates of accidental falls and pressure injuries before and after the comprehensive nursing care service was operated. Results: Comparing the accidental fall incidence rates per 100 person-months between a comprehensive nursing care ward and a general ward, it showed fewer accidental falls by 0.44 in comprehensive nursing care wards, but the result was not statistically significant. In the case of pressure ulcers, the incident rate per 100 person-month was 6.17 in general wards and 4.77 in comprehensive nursing care wards, which showed that the number of pressure ulcer patients was lower in comprehensive nursing care wards, however it was also not statistically significant. Conclusion: It is not confirmed that the operation of the comprehensive nursing care service contributes to the reduction of accidental hospital falls or pressure injuries. Follow-up studies are recommended to determine the effectiveness of comprehensive nursing services in quality indicators.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.19 no.4
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• pp.444-452
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• 2012

Purpose: To explore the usefulness of previous fall history as a triage variable for inpatients. Methods: Medical records of 21,382 patients, admitted to medical units of one tertiary hospital, were analyzed retrospectively. Inpatient falls were identified from the hospital's self-report system. Non-falls in 1,125 patients were selected by a stratified matching sampling with 125 patients with falls (0.59%). A comparative and predictive accuracy analysis was conducted to describe differences between the two groups with and without a history of falls. Logistic regression was used to measure the effect size of the fall history. Results: The fall history group showed higher prevalence by 9 fold than the non-fall history group. The relationships between falls and relevant variables which were significant in the non-fall history group, were not significant for the fall history group. Falls in the fall history group were 25 times more likely than in the non-fall group. Predictive accuracy of the risk assessment tool showed almost zero specificity in the fall history group. Conclusion: The presence of fall history, the fall prevalence, variables relevant to falls, and the accuracy of the risk tool were different, which support the usefulness of the fall history as a triage variable.

• Korean Journal of Adult Nursing
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• v.27 no.6
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• pp.684-694
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• 2015

Purpose: The purpose of this study was to explain fall prevention behaviors of community-dwelling elderly with osteoarthritis based on the Health Belief Model. Methods: A total of 200 older adults with osteoarthritis residing in community was recruited from July 10 to August 30, 2013. The direct and indirect effects of perceived fall risk, perceived benefits and barriers, and self efficacy of fall prevention were examined on fall prevention behaviors. Data were collected with structured questionnaires and analyzed using SPSS/WIN 20.0 and AMOS 20.0 program. Results: The hypothetical model was a good fit for the data based on the model fit indices. Among socio-demographic variables, age and fall knowledge showed significant direct effects on fall prevention behaviors. The constructed model explained 34.2% of the variance of fall prevention behaviors, including perceived fall risk and efficacy of fall prevention behaviors as significant predictors. Conclusion: The findings revealed the need to develop an effective nursing intervention to promote fall prevention behaviors of community-dwelling elderly with osteoarthritis by focusing on perceived fall risk and efficacy of fall prevention behaviors. Knowledge about fall can also be increased by an age-based education program.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.25 no.4
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• pp.269-281
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• 2018

Purpose: The purpose of this study was to build a model to predict the fall prevention behavior of nurses in small and medium sized hospitals. Methods: Participants were 382 nurses from 13 hospitals who responded to the structured self-reported questionnaire. The research model was based on previous study of fall prevention, theory of planned behavior, and the health belief model. Results: The modified model generally showed higher levels than recommended level of model fit indices and acceptable explanation. Of 17 hypothetical paths, 14 were supported. Predicting variables explained 51.6% of fall prevention behavior. The fall prevention behavior of nurses showed a direct influence of fall prevention expectations, fall prevent threats, perceived behavioral control for fall prevention, and intention to prevent falls and an indirect of influence of patient safety culture, attitude toward fall prevention, and the subjective norm. Conclusion: Findings show a need to identify a range of barrier factors to increase the benefits of fall prevention behavior and enhance the perceived control of fall prevention so that nurses will be able to promote fall prevention behavior in hospitals. Also, it is critical to increase awareness of patient safety culture among nurses.