• Title/Summary/Keyword: Patient fall

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The Effect of Knowledge, Attitude and Perceptions of Patient Safety Culture on Fall Prevention Activities in Mental Hospital Nurses (정신병원 간호사의 낙상에 대한 지식, 태도, 환자안전문화인식이 낙상예방활동에 미치는 영향)

  • Chang, Koung-Oh;Lee, Tea-Jin;Jung, Min-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.5
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    • pp.372-383
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    • 2019
  • The purpose of this study was to investigate the efforts of Knowledge, Attitude and Perceptions of Patient Safety Culture on Fall Prevention Activities in Mental Hospital Nurses. This study is a descriptive research study of 153 nurses working in Busan and Gyeongnam mental health hospitals, the data were collected from April 4 to December 31, 2018. Data were analyzed using IBM SPSS/win 24.0 program, which included t-test, ANOVA and multiple regression analysis. As a result, The attitude toward falls differed depending on subject's license or qualifications, the higher the education level. The higher the level of perceptions of patient safety culture, and the higher the work experience, the more prevention activities toward falls. The higher the perception of patient safety culture, the higher the attitude toward falls. The higher the prevention activities toward falls, the higher the attitude of falls and the perceptions of safety culture. As a result of multiple regression analysis of factors affecting Knowledge, Attitude and Perceptions of Patient Safety Culture on Fall Prevention Activities were 12.5%. Therefore, in order to promote fall prevention activities of mental hospital nurses, the knowledge needs to be expanded through continuous education. Education programs should be developed and provided to change attitudes toward falls. and At the hospital organization level, a wide range of support is required, including changes in the overall human and institutional environment for safety.

A Study on Lawsuit Cases and Measures of Emergency Medical Service (응급의료서비스 중 발생되는 소송사례와 대책 연구)

  • Kwon, Hay-Ran
    • The Korean Journal of Emergency Medical Services
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    • v.13 no.3
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    • pp.77-90
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    • 2009
  • Civil complaints and lawsuits filed in the process of providing emergency medical service include fall accident on the way of carrying the patient, transfer consent, refusal and rejection of rescue request, range and behavior restriction of emergency medical technicians, false registry of logbook, neglect of duty and emergency patient, and violation of traffic laws on the way of dispatch to the scene of accident. This study suggested the measures by cases as follows. 1. The accidents on the way of carrying a patient could be divided into fall of patient and fall by paramedic's mistake. In the former case, damages caused by the ambulance's shaking must be notified to the patient and guardian and recommended to fasten seat belt, in the latter case, the plan of patient's posture, route of transport, rescue and equipments should be comfirmed before fixing the patient. 2. Transfer consent must be made as implied when the patient is unconscious under delusion and was not able to consent physically, and paramedic must take an action by his judgment and record details of services on logbook. 3. When a patient refused to transfer, get 'confirmation of transfer refusal' and inform him of refusal. Paramedic should receive the signature. In addition, in case of refusal, transfer request should be made after hearing doctor's opinion and it should be notified to transfer request and superintendent of fire station after making 'confirmation of transfer refusal'. 4. Emergency medical technicians should perform their duties within the range of services prescribed by Article 41 of Law of Emergency Medical Service and Article 33 of Its Enforcement Regulations and shall not make announcement of death. In case of reporting the death to guardian, it is desirable to use record data like ECG results. 5. The best way to have protection from legal problems is making and keeping the exact records of accident and patient. Paramedic should not mention his subjective opinion about the accident-related matter. He must record correctly and keep the original medical records. 6. As emergency medical technicians are responsible for taking care of emergency patients, they must contact a briefing room when they meet a difficult situation suddenly due to vehicle stop or treatment of other patients and then must have support from neighboring hospital and other safety centers. 7. Since the ambulance operator is responsible for safety and careful driving of ambulance, he must be careful when he violates traffic regulations unavoidably. The operator should drive slowly below 10km/h at an intersection and pass it after getting way from general vehicles driving from all directions.

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Identifying Characteristics of Fall Episodes and Fall-related Risks of Hospitalized Patients (일 종합병원 입원 환자의 낙상 실태 및 위험 요인 분석)

  • Kang, Young Ok;Song, Rhayun
    • Journal of muscle and joint health
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    • v.22 no.3
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    • pp.149-159
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    • 2015
  • Purpose: This study aimed to identify falls and related risks of hospitalized patients in order to provide an baseline data to develop effective nursing intervention programs for fall prevention. Methods: The data on 120 patients who experienced falls from 2010 to 2013 during their hospitalization were collected from the patient' electronic medical records of an university hospital. Data were analyzed with descriptive statistics using SPSS/WIN 20.0. Results: Over 60% of the patients who experienced falls during their hospitalization was 65 years or older, and most of them had hypertension. Majority of the subjects needed help to perform daily activities (64%) and complained of general weakness (49.2%). Prior to the falls, the patients were taking average 2.52 medications to treat hypertension. The Fall accident was mostly frequently occurred in their hospital room (59.2%), or in bed (44.2%). The patients aged 70 years and older were significantly less alert than younger group, and taking more cardiovascular medications. Most fall risk factors were not significantly different for age, gender, and department category. Conclusion: The study findings suggest the need to emphasize the nurses to be more actively aware of fall risk factors and to provide aggressive interventions for preventing falls in hospitalized patients.

A Meta-analysis of the Risk Factors related to Falls among Elderly Patients with Dementia (치매노인의 낙상위험요인에 관한 메타분석)

  • Hong, SunYoung;Park, Heeok
    • Korean Journal of Adult Nursing
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    • v.29 no.1
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    • pp.51-62
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    • 2017
  • Purpose: The purpose of this study was to provide data about the risk factors related to falls among elderly patients with dementia using meta-analysis. Methods: Key words used for search through electronic database (CINAHL, PubMed, Ovid-MEDLINE, RISS, KISS, DBPIA, National Assembly Library) included 'dementia', 'Alzheimer', 'fall'. Twenty studies met the inclusion criteria for the meta-analysis and 'R' version 3.2.2 was used to analyze the correlated effect size. Results: Study results showed that risk factors related to falls were identified as the demographic (age, gender, education), dementia-related (disease duration, cognition), physical (body mass index, walking, balance, activity of daily living, use of walking aids, number of medications including psychotropic drugs, musculoskeletal problems, parkinsonism, comorbidity), psychological (neuropsychiatric symptom, depression), environmental (Physical environment), and fall-related (fall history, high risk group of fall) factors. The effect size of risk factors such as high risk group of fall (r=.35), use of walking aids (r=.33), depression (r=.31), psychotropic drugs (r=.27), Musculoskeletal problems (r=.25) were higher than the other risk factors. Conclusion: Based on the findings of this study, strategies to improve elderly patient's depression, intensive care for high risk group of fall, and adequate training with walking aids are needed for prevention of falls in elderly patients with dementia.

Mild Bradykinesia Due to an Injury of Corticofugal-Tract from Secondary Motor Area in a Patient with Traumatic Brain Injury

  • Lee, Han Do;Seo, Jeong Pyo
    • The Journal of Korean Physical Therapy
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    • v.33 no.6
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    • pp.304-306
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    • 2021
  • Objectives: We report on a patient who showed mild bradykinesia due to injury of the corticofugal tract (CFT) from the secondary motor area following direct head trauma, which was demonstrated on diffusion tensor tractography (DTT). Case summary: A 58-year-old male patient underwent conservative management for subarachnoid hemorrhages caused by direct head trauma resulting from a fall from six-meter height at the department of neurosurgery of a local hospital. His Glasgow Coma Scale score was 3. He developed mildly slow movements following the head trauma and visited the rehabilitation department of a university hospital at ten weeks after the fall. The patient exhibited mild bradykinesia during walking and arm movements with mild weakness in all four extremities (G/G-). Results: On ten-week DTT, narrowing of the right CFT from the supplementary motor area (SMA-CFT), and partial tearing of the left SMA-CFT, left CFTs from the dorsal premotor cortex (dPMC-CFT) and both corticospinal tracts (CSTs) at the subcortical white matter were observed. Conclusion: This case demonstrated abnormalities in both CSTs (partial tearing at the subcortical white matter and narrowing), both SMA-CFTs (narrowing and partial tearing) and left dPMC-CFT. We believe our findings suggest the necessity of assessment of the CFTs from the secondary motor area for patients with unexplained bradykinesia following direct head trauma.

Nurse-perceived Patient Adverse Events and Nursing Practice Environment

  • Kang, Jeong-Hee;Kim, Chul-Woung;Lee, Sang-Yi
    • Journal of Preventive Medicine and Public Health
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    • v.47 no.5
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    • pp.273-280
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    • 2014
  • Objectives: To evaluate the occurrence of patient adverse events in Korean hospitals as perceived by nurses and examine the correlation between patient adverse events with the nurse practice environment at nurse and hospital level. Methods: In total, 3096 nurses working in 60 general inpatient hospital units were included. A two-level logistic regression analysis was performed. Results: At the hospital level, patient adverse events included patient falls (60.5%), nosocomial infections (51.7%), pressure sores (42.6%) and medication errors (33.3%). Among the hospital-level explanatory variables associated with the nursing practice environment, 'physician-nurse relationship' correlated with medication errors while 'education for improving quality of care' affected patient falls. Conclusions: The doctor-nurse relationship and access to education that can improve the quality of care at the hospital level may help decrease the occurrence of patient adverse events.

A study on the Design of Fall Protection system for Patient Protection (환자보호를 위한 낙상방지 시스템 설계에 관한 연구)

  • Cho, Youngseok
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2018.07a
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    • pp.17-18
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    • 2018
  • 본 논문에서는 병실의 침대 위에서 움직임으로 침대 밖으로 떨어지는 것을 방지하기 위한 환자감시 시스템인 낙상 방지 시스템을 제안한다. 환자는 휴식을 취하거나 각종 처치를 위하여 침대에 머무르게 된다. 이 과정에서 대부분의 환자들은 기력이 낮아지고 자기 신체에 대한 제어 능력이 낮아져 침대의 바깥쪽으로 움직이는 경우가 종종 발생한다. 본 논문에서는 초음파를 이용한 환자까지의 거리 맵을 생성한 다음 거리 맵을 기반으로 환자의 위치를 추정하였다. 경과 측정거리는 10mm 이내로 측정이 가능하였고, 기존의 방식과 비교하여 내구성과 활용성이 우수하였다.

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Perception of the Nurse on the Nursing Malpractice and Its Case (간호사고와 관련판례에 대한 임상간호사의 지각)

  • Jeong, Ji-Yun;Lee, Myung-Ha
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.3
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    • pp.445-462
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    • 1999
  • The purpose of this study is to provide some basic data for the direction of nursing education and practice to prevent nursing malpractice as investgating perception of the nurse on the nursing malpractice and its case. Data were collected from 450 nurse working in four general hospitals which were located in Chonbuk province from November 9 to 21, 1998 through questionnare. The structured instruments developed by the reseacher were used for collecting data. The Results were as follows: 1) As for the cognition of the nursing malpractice case, the transfusion accident was 37.3%, the side-effects of KCL injection(19.3%), hymen rupture by uterus cancer test, the side-effects of aminophyllin injections on dyspnea patient and the others were 10% below. 2) With regard to the channel of the perception of the nursing malpractice case, mass-communication was taken first and followed through by neighbors, In-service education, school education, continuing education 3) As for the direct${\cdot}$indirect experience of the nursing malpractice case, transfusion accident was 51.3%, the fall of NPO patient after an operation 40.1%, the side-effect of KCL injection 32.5%, suicide of the psychiatric patient 32.5%, and the others were 30% below. 4) The possibility of nursing malpractice case was an average 2.57(${\pm}$0.91) and the highest was the fall of the NPO patient after an operation. 5) The perception on the responsibility of the nursing malpractice in its case was indicated as a joint-fault in ten nursing malpractice instances. As compared to the real decision, nurse's perception of the responsibility in the fall of the NPO patient after an operation, the side-effect of KCL injection, the tracheal edema of the patient who had a thyroid operation, the suicide of psychiatric patient, the hymen rupture by uterus cancer test accorded real decisions. But the other cases were different from the real decisions. These cases were perceived as ones of joint fault even in cases determined as Dr's single fault cases or those in which both doctor and nurse were declared free of fault. 6) Knowledge levels of the nursing malpractice, school education and In-service education were perceived as low but anxiety levels of the malpractice were high. 7) With regard to the countmeasure of the hospital after nursing malpractice, the rate answered as "the practice settled the accident temporarily and forced the person in charge to be punished" was highest. In conclusion, the level of the cognition of the clinical nurse on nursing malpractice cases was low. As nurses' perception on the responsibility of the nursing malpractice case was compared to the real decision, there was a difference in five cases out of the ten cases.

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Psychometric Properties of the Fall Risk Perception Questionnaire-Short Version for Inpatients in Acute Care Hospitals

  • Choi, Jeeeun;Lee, Sujin;Park, Eunjin;Ku, Sangha;Kim, Sunhwa;Yu, Wonhye;Jeong, Eunmi;Park, Sukhee;Park, Yusun;Kim, Hye Young;Kim, Sung Reul
    • Journal of Korean Academy of Nursing
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    • v.54 no.2
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    • pp.151-161
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    • 2024
  • Purpose: Patients' perception of fall risk is a promising new indicator for fall prevention. Therefore, a fall risk perception questionnaire that can be used rapidly and repeatedly in acute care settings is required. This study aimed to develop a short version of the fall risk perception questionnaire (Short-FRPQ) for inpatients. Methods: For the psychometric measurements, 246 inpatients were recruited from an acute care hospital. The construct (using confirmatory factor analysis and discriminant validity of each item), convergent, and known-group validities were tested to determine the validity of the Short-FRPQ. McDonald's omega coefficient was used to examine the internal consistency of reliability. Results: In the confirmatory factor analysis, the fit indices of the Short-FRPQ, comprising 14 items and three factors, appeared to be satisfactory. The Short-FRPQ had a significantly positive correlation with the original scale, the Korean Falls Efficacy Scale-International, and the Morse Fall Scale. The risk of falls group, assessed using the Morse Fall Scale, had a higher score on the Short-FRPQ. McDonald's omega coefficient was .90. Conclusion: The Short-FRPQ presents good reliability and validity. As patient participation is essential in fall interventions, evaluating the fall risk perception of inpatients quickly and repeatedly using scales of acceptable validity and reliability is necessary.

A Case Study of Fibromyalgia with Insomnia and Dry Mouth Treated with Korean Medicine including Guibiondam-tang-gagam (귀비온담탕가감(歸脾溫膽湯加減)을 포함한 한방치료로 호전된 섬유근육통 환자의 불면 및 구강건조 치험 1례)

  • Yang, Ji-soo;Lee, Su-jung;Cho, Eun-chai;Lew, Jae-hwan
    • The Journal of Internal Korean Medicine
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    • v.43 no.2
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    • pp.152-158
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    • 2022
  • Objective: This study addresses a case of fibromyalgia with insomnia and dry mouth. Methods: A patient diagnosed with fibromyalgia was treated with Korean medicine including herbal therapy with Guibiondam-tang-gagam, acupuncture, pharmacopuncture, moxibustion, and chuna for 16 days. To evaluate the therapeutic effects, sleeping hours, time taken to fall asleep, and surprise on waking were assessed, and a numeric rating scale (NRS) was used to monitor dry mouth. Results: After treatment, the patient's sleeping hours increased, time taken to fall asleep decreased, and the patient woke up surprised less often. The NRS score for dry mouth also decreased. Conclusion: These results suggest that Korean medicine therapies with Guibiondam-tang-gagam have a beneficial effect on insomnia and dry mouth as additional symptoms of fibromyalgia.