• 가정간호학회지
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• 제25권3호
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• pp.182-190
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• 2018

Purpose: This study was conducted to identify and analyze the types, characteristics, and frequency of patient safety accidents among hospitalized children. Methods: The data were collected from patient safety reports for 0-19-year-old patients from the National Health Insurance Corporation (NHIC) from January 1, 2016 through December 31, 2017. Using Excel software, a pivot table was used to classify and analyze the safety incidents, severity frequency, and characteristics of hospitalized child patients. Results: A total of 254 accident cases were reported involving child patients. The types of reports included medication accidents, falls, test errors, and others. Medication accidents accounted for 47.2% of the total reported cases. Regarding the severity of reported risk, there were no complications nor sequelae in 80.4% of the cases. Conclusion: This study is significant for systematically analyzing and reporting data reported about safety accidents among hospitalized children. These results will contribute further to preventing safety accidents in hospitalized children and to creating a desirable patient safety culture.

• Journal of Trauma and Injury
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• 제19권1호
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• pp.54-58
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• 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.

• The Journal of Korean Physical Therapy
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• 제35권6호
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• pp.190-194
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• 2023

Purpose: Traumatic brain injury (TBI) refers to brain damage caused by external forces or trauma. TBIs can vary in severity and result from accidents, falls, sports injuries, assaults, or other forms of physical trauma. The prefrontal cortex (PFC) is known have roles in various cognitive functions. We report on a patient with traumatic brain injury who showed prefrontal symptoms after injury of thalamocortical connections between mediodorsal nuclei (MD) of thalamus and PFC. Methods: A 54-year-old, male patient suffered a TBI as a result of a heavy object falling on his head. After onset of TBI, he showed typical symptoms of prefrontal lobe injury, including personality changes, memory impairment, and general cognition problem. The thalamocortical connections between MD and PFC (ventrolateral prefrontal cortex (VLPFC), dorsolateral prefrontal cortex (DLPFC), and obrbitofrontal cortex (OFC)) were reconstructed using diffusion tensor tractography. In terms of fractional anisotropy value, the right thalamocortical connections to the OFC were significantly lower than those of control subjects. Results: The value of mean diffusivity in the right thalamocortical connections to the DLPFC was significantly higher than that of control subjects. By contrast, both VLPFC and left OFC showed significant decrement in the tract volume of thalamocortical connections compared with that of control subjects. Conclusion: We reported on a patient who showed cognitive and neuropsychiatric impairment due to global injury of the thalamocoritcal connections between MD and PFC following TBI.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권3호
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• pp.183-190
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• 2020

Objectives: The purpose of this retrospective epidemiological study was to determine the etiology and pattern of maxillofacial injuries in a pediatric population. Materials and Methods: Data for pediatric maxillofacial trauma patients aged 12 years and younger who were registered at the Department of Pediatric and Preventive Dentistry, Dr. R. Ahmed Dental College and Hospital, Kolkata, India, were reviewed and examined. Patients who were treated between October 2016 and September 2018 were analyzed according to age, sex, cause of injury, frequency and site of facial fractures, and soft tissue injuries. The chi-square tests were carried out for statistical analyses with a significance level of 5%. Results: Of 232 patients with a mean age of 6.77±3.25 years, there were 134 males (57.8%) and 98 females (42.2%). The overall male to female ratio was 1.39:1. The most common causes of injuries were falls (56.5%) and motor vehicle accidents (16.8%). Incidence of falls decreased significantly with age (P<0.001). Dentoalveolar injuries (61.6%) and soft tissue injuries (57.3%) were more common than facial fractures (42.7%). Mandibular fractures (82.8%) were the most common facial fractures, and perioral or lip injuries were the most prevalent injuries in our patient population. There was a positive association between facial fractures and soft tissue injury (P<0.01) (odds ratio 0.26; confidence interval 0.15-0.46). Conclusion: Falls were the leading cause of maxillofacial trauma in our sample of children, and the most common site of fractures was the mandible.

• 대한골대사학회지
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• 제25권4호
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• pp.267-274
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• 2018

Background: This prospective cohort study used nationwide claims data to investigate the incidence of fall and fragility fractures in association with urinary incontinence (UI) in the elderly, and to compare mortality after fragility fractures in elderly patients with or without incontinence. Methods: A total of 39,854 Korean adults (age, 66-80 years) who participated in health examinations between 2007 and 2012 and were followed up until 2015 were analyzed. Patient and comparison groups were classified according to the presence or absence of UI. The cumulative incidence of osteoporotic fragility fractures and falls in the 2 groups was assessed and compared. Hazard ratios for fragility fractures were calculated for the risk of UI in association with falls using a Cox proportional hazards model. Results: Of 39,854 elderly participants, 5,703 were classified in the UI group, while 34,151 were placed in the comparison group. Fall rates were significantly higher (20.8%) in the incontinence group than in the comparison group (4.7%) (P<0.001). Women in the incontinence group (13.9%) showed a significantly higher incidence of all types of fragility fractures than those in the comparison group (11.8%) (P=0.005). After adjustment for confounders, UI was not a significant risk factor for fragility fractures in men (P=0.878) or women (P=0.324). Conclusions: This study demonstrated that elderly women with UI have a significantly higher incidence of osteoporotic fragility fractures. In addition, elderly women are at higher risk for falls.

• 대한간호학회지
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• 제54권2호
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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.

• 대한물리의학회지
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• 제6권1호
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• pp.9-17
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• 2011

Purpose : The purpose of this study was to compare the effects of performing feedback vs repeative tasks on lower extremity motor function and falls efficacy in chronic hemiplegic patients. Methods : 40 hemiplegic patients took part in this study. The average age of the feedback-task group was 68.45 years and 68.20 in the repeative-task group. All subjects participated in the study for 8 weeks, doing exercises 3 per day per week. All participants were assessed by using the Berg balance scale (BBS), the lower-extremity subscale of the Fugel-Meyer assessment of sensorimotor impairment (FMLE), and the falls efficacy scale (FES). The data were analyzed using a paired t-test. Results : After 8 weeks of exercise training, the results of this study were: the BBS and FMLE of hemiplegic patients showed a feedback-task and repeative-task groups (p<0.05). The FES of hemiplegic patients also showed a significant difference between the quantitative-task and qualitative-task groups (p<0.05). Conclusion : We present findings suggesting that chronic hemiplegic patients could improve their standing balance ability better through a feedback-task exercise program, as opposed to a repeative-task exercise program.

• 성인간호학회지
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• 제25권1호
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• pp.74-82
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• 2013

Purpose: The purpose of this study was to identify the fall risk factors and to evaluate the effectiveness of the Morse Fall Scale(MFS) as an assessment tool among hospitalized inpatients. Methods: The medical records of a total of 294 patients who admitted to hospital from January 1 to December 31, 2010 were reviewed. One hundred forth seven patients who had experienced fall were matched with 147 patients who have never experienced fall. The fall information was obtained from electronic medical records and fall reports. Results: There were significant differences in visual disturbances, pain, emotional disturbances, sleep disorder, urination problems and elimination disorder at admission between fallers and non-fallers. Patients who had higher MFS scores at admission were more likely to fall as compared to the patients with lower MFS scores. When falls did occur, these occurred within five days following admission, in the patient room, among patients with alert mental status, and among patients who were ambulant with some assistance. Conclusion: The findings of this study support the need of using risk assessment tool for predicting risk for falls. This finding can be used as a useful resource to develop nursing intervention strategies for fall prevention at the hospital.

• Child Health Nursing Research
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• 제25권1호
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• pp.56-64
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• 2019

Purpose: This study was conducted to obtain data for the development of an effective fall risk assessment tool for pediatric inpatients through a systematic review and meta-analysis of the diagnostic test accuracy of existing scales. Methods: A literature search using Medline, Science Direct, CINAHL, EMBASE, and the Cochrane Library was performed between March 1 and 31, 2018. Of 890 identified papers, 10 were selected for review. Nine were used in the meta-analysis. Stata version 14.0 was used to create forest plots of sensitivity and specificity. A summary receiver operating characteristic curve was used to compare all diagnostic test accuracies. Results: Four studies used the Humpty Dumpty Falls Scale. The most common items included the patient's diagnoses, use of sedative medications, and mobility. The pooled sensitivity and specificity of the nine studies were .79 and .36, respectively. Conclusion: Considering the low specificity of the pediatric fall risk assessment scales currently available, there is a need to subdivide scoring categories and to minimize items that are evaluated using nurses' subjective judgment alone. Fall risk assessment scales should be incorporated into the electronic medical record system and an automated scoring system should be developed.

• 한국융합학회논문지
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• 제9권1호
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• pp.103-109
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• 2018

최근 환자안전에 대한 관심이 점점 증가하고 환자안전 문제의 심각성이 대두되고 있는 시점에서 의료계의 환자안전에 관한 다양한 연구가 융합되어 많은 활동이 이루어지고 있다. 이에 본 연구는 의료기관에서 근무하는 다양한 직종의 의료종사자들의 환자안전 문화에 대한 인식을 측정하고 유용한 지표로 활용되고자 시도하였다. 의료종사자 총 180명을 대상으로 부서(병동) 및 병원의 환자안전 문화 인식, 직속상관/관리자, 의사소통과 절차, 환자안전 사건보고, 가장 위험하다고 생각되는 환자안전 사고에 관해 평가한 결과, 부서(병동)의 환자안전 문화 인식 영역은 보건직, 직속상관/관리자 영역은 간호직이 높은 결과를 나타냈고, 방사선사와 물리치료사는 낙상, 임상병리사와 간호사는 검사 전 중 후 오류를 가장 위험한 환자안전 사고로 인식하였다. 따라서 환자안전 문화 인식을 높이기 위해 경영진 및 실무자는 적절한 인력 확보, 직원 간 또는 부서 간 협조 시스템 및 안전관리 활동에 필요한 동기 부여에 더 많은 노력을 기울여야 할 것이다.