Background: The purpose of this research was to examine the fall incidence rate and its related factors of fall in inpatients. Methods: The data were collected from the 138 fall incident reports in one tertiary hospital in Seoul from April 1st 1999 to September 30th 2001. The Fall Incident Report Form was originally developed based on that of Massachusetts General Hospital revised in 1995. And this was modified for this survey by the collaborating work of QI team including researcher and department of nursing service of this particular hospital. The contents of Fall Incident Form were general characteristics of patient. factors related to fall. types and places of fall. circumstances, nursing interventions. and outcome. Results: 1) The incidence rate of fall was 0.08% of total discharged patients and 0.081 per 1000 patient-day. This incidence rate is much lower than that of several hospitals in USA. This finding might result from the different incidence report system of each hospital. 2) The characteristics of fall-prone patient were found as follows. They were mostly over 60 years old, in alert mental status, ambulatory with some assistance, and dependent on ambulatory device. The types of diseases related high incidence rate were cerebrovascular disease(3.2), hypertension(1.6), cardiovascular disease(1.4), diabetes(1.3) and liver disease(0.6). 3) The majority of fall events usually occurred m bed. bedside(walking or standing) and bathroom in patient room. Usually they were up on their own when they fell. And there were more falls of elderly occurred during night time than day or evening. 4) 63.8% of fall events resulted in physical injuries such as fracture and usually the patients had diagnostic procedures and some treatment(ex. suture) which caused additional cost to the patients and their families. 5) The found risk factors of fall were drugs(antihypertensive drug, diuretics) and environmental factors like too high bed height, long distance of bedside table and lamp switch, and slippery tile of bathroom floor. Conclusion: Considering these results, every medical and nursing staff should be aware of the risk factors of patients in hospital, and should intervene more actively the preventive managements, specially for the elderly patients during night. Therefore, it is recommended that the development of Fall Prevention Programs based on these results.
Purpose: This study is to identify how eye movement influences the static balance and fall efficacy of the elderly who have experienced fall-related injuries. Methods: Thirty nine elderly who scored 24 points in the Korean mini mental state examination, were able to walk, and had no specific disease, were selected as the research subjects among elderly who have experienced fall-related injury more than once in the past year. Thus, 20 for the experimental group, and 19 for the control group were selected as subjects. The experiment was conducted for 6 weeks, including periods of evaluation before and after intervention. Results: The results with respect to the dependent variables are as follows: Substitute sample t-testing showed significant differences between each group in eye movement to check difference in balance performance and fall efficacy. When independent sample t-tests were conducted to compare static balancing performance and fall efficacy between the two groups after intervention, they showed significant differences in statistical terms (p<0.05). Conclusion: From the above results of the study, it was found that the application of eye movement combined with diverse fall prevention programs is effective, when enhancing static balance performance power and improving fall efficacy.
Fall-related injuries in elderly people are a major health care problem. This paper introduces determination of fall direction before impact using support vector machine (SVM). Once a falling phase is detected, dynamic characteristic parameters measured by the accelerometer and gyroscope and then processed by a Kalman filter are used in the SVM to determine the fall directions, i.e., forward (F), backward (B), rightward (R), and leftward (L). This paper compares the determination sensitivities according to the selected parameters for the SVM (velocities, tilt angles, vs. accelerations) and sensor attachment locations (waist vs. chest) with regards to the binary classification (i.e., F vs. B and R vs. L) and the multi-class classification (i.e., F, B, R, vs. L). Based on the velocity of waist which was superior to other parameters, the SVM in the binary case achieved 100% sensitivities for both F vs. B and R vs. L, while the SVM in the multi-class case achieved the sensitivities of F 93.8%, B 91.3%, R 62.3%, and L 63.6%.
Floor slipperiness is a leading cause in slip and fall accidents which are a major source of occupational injuries in Korea. Researchers have estimated the slip and fall related accidents rank number one or two in number of the injured. The objectives of this study were to find the field contamination effect and improvement countermeasure. Slipping and falling are common accidents in large public facilities, especially facility which vulnerable adults generally use as like hospital. So, we measured the coefficient of friction of several floors on the floor in hospital, under dry and wet using BOT-3000. The results of the coefficient of friction measurements showed that floor type and surface conditions were all significant factors affecting the coefficient of friction. The most surprising finding of this study was that there were significant friction improvement when the floors were properly cleaned with cleaning equipments.
Purpose: The purpose of this study is to analyze the realities related with the in-home falls of the elderly and also the factors that affect on the fails. Method: The data collection was carried out from January 10 to 13, 2005. The subjects of this study were 201 in-home elderly people over age 60 who resided at G city of Jeollabuk-do. Result: The following are the results from the analysis of collected data with using the SPSS program. 1. The number of people who experienced fall injuries was 51.7% within three years. Most cases of falls occurred in winter (52.4%), on roads (52.9%), wearing sports shoes (56.7%), when walking (56.7%), loosing their balance (54.8%), and slipping (54.8%). 2. The factors yielding the difference between the groups of elderly with the experience of fail injury and the group of elderly with no experience of falls showed a statistical significance for gender (p=.000), last academic career (p=.049), and number of people in the family (p=.041). 3. Among the factors related with health, the factors yielding the difference between the group of elderly with the experience of falls and the group of elderly with no experience of fails showed statistical significance for drinking (p=.015), dizziness (p=.000) and level of drug intakes (p=.015). 4. The elderly with the experience of fall injury as compared with the group of aged people with no experience of falls showed a higher degree of depression (p=.009). 5. From the result of logistic regression analysis to explore the factors affecting the experience of fall injury, it was found that there was a significant result for gender (p=.002) and depression (p=.018). Women as compared with men and the elderly with depression showed a higher rate of danger in falls. Conclusion: Based on the above results, it is expected that fall prevention programs are needed with regard to the general characteristics and health related characteristics, that is, the individual danger factors should be focused on such depression and gender as being the most important variables affecting the experience of falls.
Balance can be defined as the ability to maintain the body's center of gravity within the base of support with minimal sway. Falls occur frequently in the elderly persons by the physiological change and dysfunction with age. Injuries resulting from falls include soft tissue damage and fractures of the radius, humerus, and femoral neck other consequences of falls include decreased mobility, reduced confidence, long lies (which can give rise to hypothermia, dehydration and pneumonia), and death Risk factors for falls have beau classified as intrinsic (those related to the individual) and extrinsic(those associated with environmental features), Intrinsic factors include decreased strength, visual deficits, vestibular dysfunction, and decreased vibratory sensation in the feet. Improvement of the balance related to the increased probability for fells in the elderly persons and is important for fall preventions and improvement of the living quality ef the elderly persons
For the purpose of evaluation of clinical characteristics in multiple rib fracture due to accident , 24 cases treated by surgical rib fixation using Judet`s strut for multiple rib fracture and flail chestduring the period from June 1993 to October 1994 were reviewed. There were 17 males and 7 females.They ranged in age from 19 years old to 56 years old. The causes of rib fracture were traffic accident in 18 cases, fall down in 3 cases, compression in 2 cases stab wound in 1 case. The number of rib fracture were five in 7 cases, six in 5 cases, four in 5 cases, three in 3 cases. Associated intrathoracic injuries were hemopneumothorax in 12 cases, hemothorax in 10 cases, lung laceration or hemorrhagic contusion in 7 cases. Associated extrathoracic injuries were abdominal injuries in 21 cases, orthopedic problem in 7 cases, head trauma in 4 cases. The most common fractured site was posterolateral portion of the ribs. The causes for operation were flail chest, severe rib displacement and pain, hemothorax or hemopneumothorax with continuous air leakage and stab wound. There were 6 postoperative complications ; one with hydrothorax, two with fibrothorax, two with wound infection and one case of death due to multiful organ failure. Postoperatively, all patients became comfortable and complained less painful. Twenty patients restored spontaneous breathing without ventilator support, three patients were ventilated during a day and one patient expired after 2 days. There were no morbidity and mortality related to operation.
Objectives: To describe the rate of injuries among infants and toddlers. and to investigate the attitude. knowledge. and practice on safety of their mothers. Methods: The total sample consisted of 308 mothers with infants or toddlers from two public health centers in two cities in Kyunggi Province. A questionnaire was used to collect data. which was analyzed with SPSS 11.5 Win program. Results: Thirty-eight percent of the subjects had experienced home accidents. Fall. burn. and laceration were the most frequently occurred home injuries. Most of the mothers were anxious for child accidents, and $59.4\%$ of mothers thought of safety as a primary concern. The mean score of knowledge on safety was 7.63. and the mean score of practice on safety was 34.76. Safety knowledge was significantly higher in mothers with higher education. higher income. and experience of having information on safety. but safety practice was not different depending on these factors. There was a negative correlation between safety practice and child rearing burden. Conclusions: The rate of injuries among infants and toddlers was still high compared to other developed countries. This study provided basic data about the accidents of infants and toddlers. and the level of safety knowledge and safety practice of their mothers. The related factors found in this study should be considered when providing anticipatory guidance or developing injury prevention programs for mothers.
Slipping during various kinds of movement often leads to potentially dangerous incidents of falling. The purpose of this paper was to review some of the research performed in the field including such topics as rating scales for balance, kinematics and kinetics of slipping, adaptation to slippery conditions, postural and balance control, and protective movement during falling. Controlling slipping and fall injuries requires a multifaceted approach. Environmental conditions (state of floor surface, tidiness, lighting, etc), work task (walking, carrying, pushing, lifting, etc), and human behavior (anticipation of hazards, adaptation to risks, risk taking, etc) must be accounted for in the assessment of slip and fall-related risks. Future directions of research must deal with modeling of basic tribophysical, biomechanical, and postural control process involved in slipping and falling.
Seo, Young Woo;Hong, Jung Seok;Kim, Woo Yun;Ahn, Ryeok;Hong, Eun Seok
Journal of Trauma and Injury
/
v.19
no.1
/
pp.54-58
/
2006
Purpose: The committee on trauma of the american college of surgeons, in its manual resources for optimal care of the injured patients involved in falls from less than 20 feet need not be taken to trauma centers. Because triage criteria dictate less urgency for low-level falls, this classification scheme has demerits for early detection and treatment of serious problems in the emergency room. Methods: A prospective analysis was conducted of 182 patients treated for fall-related trauma from June 2003 to March 2004. Falls were classified as group A (<3 m), group B (${\geq}3m$, <6 m), and group C (${\geq}6m$). Collected data included the patient's age, gender, site and height of fall, surface fallen upon, body area of first impact, body regions of injuries, Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), and Injury Severity Score (ISS). Results: The 182 patients were classified as group A (105) 57.7%, group B (61) 33.5%, and group C (16) 8.8%. There was a weak positive correlation between the height of fall and the patients' ISS in the three groups (p<0.001). There were significant differences in GCS (p=0.017), RTS (p=0.034), and ISS (p=0.007) between group A and B. In cases that the head was the initial impact area of the body, the GCS (p<0.001) and the RTS (p=0.002) were lower, but the ISS (p<0.001) was higher than it was for other type of injuries. Hard surfaces as an impact surface type, had an influence on the GCS (p<0.001) and the ISS (p=0.025). Conclusion: To simply categorize patients who fall over 6 meters as severely injured patients doesn't have much meaning, and though patients may have fallen less than 6 meters, they should be categorized by using the dynamics (impact surface type, initial body - impact area) of their fall.
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