• Title/Summary/Keyword: falls

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Incidence Rate and Characteristics of Falls in Patients Using Comprehensive Nursing Care Service (간호·간병통합서비스 이용환자의 낙상발생률과 낙상의 특성)

  • Son, Jaei;Park, Byung Kyu;Lee, Chan Hee;Ahn, Keum Hui;Kim, Jung Nam;Park, Min Hyun;Choi, Eun Young;Boo, Eun Hui;Kang, Min Jin;Hong, Jung Hwa
    • Health Policy and Management
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    • v.29 no.2
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    • pp.172-183
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    • 2019
  • Background: Falls are the most frequent adverse events reported in hospitals. The aim of this study was to investigate the incidence rate and characteristics of falls in patients who used comprehensive nursing care service in National Health Insurance Service Ilsan Hospital. Methods: Incidence rate of falls was investigated in patients using comprehensive nursing care service, from July 2013 to Jun 2017 and compared with those not using this service. The characteristics and risk factors for falls, and fall-related injuries were obtained. Results: Among the 62,445 patients who used the comprehensive nursing care service for 4 years, total of 672 falls were reported. The incidence rate of falls per 1,000 patients-day was 1.15. The percentage of fall-related injuries was 26.9% and that of major injury was 2.2%. Although the incidence rate of all falls was slightly higher in patients using comprehensive nursing care service than those not using this service, falls-related injuries were not correlated with the implementation of this service. Conclusion: The falls could be more frequently detected and reported in comprehensive nursing care service, but there was no difference in fall-related injuries.

Effects of Nursing Interventions for Fall Prevention in Hospitalized Patients: A Meta-analysis (입원 환자 낙상예방 간호중재 효과에 대한 메타분석)

  • Kim, Yoon Lee;Jeong, Seok Hee
    • Journal of Korean Academy of Nursing
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    • v.45 no.4
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    • pp.469-482
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    • 2015
  • Purpose: The purpose of this study was to identify which nursing interventions are the most effective in fall prevention for hospitalized patients. Methods: From 3,675 papers searched, 34 were selected for inclusion in the meta-analysis. Number of fallers, falls, falls per 1,000 hospital-days, and injurious falls, fall protection activity, knowledge related to falls, and self-efficacy about falls were evaluated as outcome variables. Data were analyzed using the Comprehensive Meta Analysis (CMA) 2.2 Version program and the effect sizes were shown as the Odd Ratio (OR) and Hedges's g. Results: Overall effect size of nursing interventions for fall prevention was OR=0.64 (95% CI: 0.57~0.73, p <.05) and Hedges's g= - 0.24. The effect sizes (OR) of each intervention ranged from 0.34 to 0.93, and the most effective nursing intervention was the education & environment intervention (OR=0.34, 95% CI: 0.28~0.42, p<.001), followed by education intervention (OR=0.57, 95% CI: 0.50~0.67, p=.001). Subgroup analyses showed that multifaceted interventions (OR=0.76, 95% CI: 0.73~0.79, p<.001) were more effective than unifactorial interventions, and that activities for prevention of falls (OR=0.08, 95% CI: 0.05~0.15, p<.001) showed the largest effect size among outcome variables. Conclusion: Falls in hospitalized patients can be effectively prevented using the nursing interventions identified in this study. These findings provide scientific evidence for developing and using effective nursing interventions to improve the safety of hospitalized patients.

Comparisons of the Falls and Intrinsic Fall Risk Factors according to Gender in the elderly at Ttransitional Periods of Life (생애전환 초기 노인의 성별에 따른 낙상경험 및 내재적 요인 비교)

  • Yim, Eunshil;Kim, Dosuk;Kim, Bohwan
    • The Journal of the Korea Contents Association
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    • v.13 no.12
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    • pp.276-290
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    • 2013
  • PURPOSE: This study compared the elderly falls and the intrinsic fall risk factors according to gender. METHODS: This descriptive cross-sectional study was a secondary analysis of the data collected for medical checkups for the Transitional Periods of Life supported from the National Health Insurance. The subjects examined were 255,505 people aged 66 years in Korea between January and December, 2008. RESULTS: The elderly people aged 66 when in the transitional periods of life experienced 10.6% of their first falls. The first falls of women (12.4%) was greater than that of men (8.5%) in the elderly. The risk factors for falls included dysuria with an odds ratio of 6.2 to 6.6, depression with an odds ratio of 1.5 to 1.8, gait disturbance with an odds ratio of 1.3 to 1.5, and blindness with an odds ratio of 1.3 to 1.4 in both elderly women and men. CONCLUSIONS: Effective fall prevention should focus on dysuria because it is a more important predictor of falls, even though many intrinsic fall risk factors can affect falls in elderly people.

A Comparison of Assessment Tools for Prediction of Falls in Patients With Stroke (뇌졸중 환자의 낙상 예측을 위한 평가도구 비교)

  • Won, Jong-Im
    • Physical Therapy Korea
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    • v.21 no.2
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    • pp.37-47
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    • 2014
  • Falls are common after stroke and most frequently related to loss of balance while walking. Consequently, preventing falls is one of the goals of acute, rehabilitative, and chronic stroke care. The purpose of this study was to investigate the incidence and risk factors of falls and to determine how well the Falls Efficacy Scale (FES), Timed Up and Go test (TUG), and Berg Balance Scale (BBS) could distinguish between fallers and non-fallers among stroke patients during inpatient rehabilitation. One hundred and fifteen participants with at least 3 months post-stroke and able to walk at least 3 m with or without a mono cane participated in this study. Fifty-four (47%) participants reported falling, and 15 (27.8%) had a recurrent fall. Logistic regression analysis for predicting falls showed that left hemiplegia [odds ratio (OR)=4.68] and fear of falling (OR=5.99) were strong risk factors for falls. Fallers performed worse than non-fallers on the FES, TUG, and BBS (p<.05, p<.01, respectively). In the receiver operator characteristic curve analysis, the TUG demonstrated the best discriminating ability among the three assessment tools. The cut-off score was 22 seconds on the TUG for discriminating fallers from non-fallers (sensitivity=88.9%, specificity=45.9%) and 27 seconds for discriminating recurrent fallers from single fallers and non-fallers (sensitivity=71.4%, specificity=40.2%). Results suggest that there is a need for providing fall prevention and injury minimization programs for stroke patients who record over 22 seconds on the TUG.

Comparative Study on Fall Related Characteristics between Single and Recurrent Falls in Community-Dwelling Older Women (재가 여성노인에서 1회 낙상군과 반복낙상군의 낙상관련 특성 비교연구)

  • Park, Hyoung-Sook;Chang, Rang;Park, Kyung-Yeon
    • Korean Journal of Adult Nursing
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    • v.20 no.6
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    • pp.905-916
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    • 2008
  • Purpose: The purpose of this study was to identify the influencing factors on the single and recurrent falls in community-dwelling older women. Methods: Seventy eight volunteers aged over 65 were included in the study. The participants experienced at least one fall within the past one year. Data were measured on each participant from May 2007 to September 2007, collected using structured researcher-administered sheets and measuring their physical strengths and analyzed by descriptive statistics, t-test, chi-square test, Mann-Whitney U test and logistic regression analysis. Results: The prevalence of recurrent falls were 53.8%. The level of education(Z = -2.455, p = .014) and the presence of spouse($x^2$ = 4.843, p = .044) showed significant differences between the single-fall group and the recurrent-fall group in the study. Significantly predicting factor on the recurrent falls was the level of education and the variable explained 20.1% of variants in the occurrence of recurrent falls. Conclusion: Although a variety of factors affected the single fall in the elderly women, the level of education and the presence of spouse proved to be the significant factors in their recurrent falls. These factors proven to be significant as the result of this should be reflected in the development of effective programs for preventing the elderly from recurrent falls.

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The Prevalence and Associated Factors of the in-home Falls of the Elderly (재가노인의 낙상에 영향을 미치는 요인)

  • Mun, Young-Hee
    • Journal of Korean Public Health Nursing
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    • v.19 no.2
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    • pp.249-260
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    • 2005
  • 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.

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Sensor Module for Detecting Postural Change and Falls

  • Jeon, G.R.;Ahn, S.J.;Shin, B.J.;Kang, S.C.;Kim, J.H.
    • Journal of Sensor Science and Technology
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    • v.23 no.6
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    • pp.362-367
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    • 2014
  • In this study, a postural change detection sensor module (PCDSM) was developed to detect postural changes in activities of daily living (ADL) and falls. The PCDSM consists of eight mercury sensors that measure angle variations in $360^{\circ}$ rotation and $90^{\circ}$ tilting. From the preliminary study, the output characteristics of the PCDSM were confirmed with the angle variations of rotational motion and a tilting table. Three experiments were conducted to test rotational motion, postural changes, and falling and lying. The results confirmed that the PCDSM could effectively detect postural changes, movement patterns, and falls or non-falls.

A Study of ADL, Medications and Falls Frequency in Community-dwelling Elderly (재가노인의 일상생활활동, 투약 및 낙상에 관한 연구)

  • Jeon, Eun-Young;Kim, Sook-Young
    • The Korean Journal of Rehabilitation Nursing
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    • v.11 no.2
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    • pp.107-113
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    • 2008
  • Purpose: The purpose of this study was to identify the risk factors for falls among the elderly living in community. Method: This was a descriptive study. The subjects comprised 80 elderly aged 65 years or over living in D city. The instruments used for this study was the MDS-HC V2.0. The data was analyzed by SPSS Win 14.0 using t-test, ANOVA, and Pearson correlation. Result: Among the socio-demographic characteristics, the significant differences were found in ADL by gender and marital status. Older elderly(${\geq}85$) used more medications than other elderly. The elderly were use average 4.33 medications, but 46.3% of the subjects didn't have the physician reviewed all medications. There was statistically significant correlation between number of medications and accidental falls. Conclusion: Nurses should inspect about the number of medications, drug interaction, and side effects. It would be preventive intervention for falls in elderly.

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The Prevalence and Factors of Falls among the Community-Dwelling Elderly (재가 노인의 낙상 경험률과 관련 요인)

  • Jang, Insun;Park, Eunok
    • Journal of Korean Public Health Nursing
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    • v.27 no.1
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    • pp.89-101
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    • 2013
  • Purpose: The purpose of this study was to investigate the prevalence, characteristics, and factors related to falls occurring among the community-dwelling elderly. Methods: The subjects were 299 community-dwelling-elderly in Jeju Province. Data were collected via in-person interviews by five visiting nurses in October, 2012. Fall risk assessment tools developed by the CDC, K-ADL, HDS-K, and GDS were used for data collection. Results: A significant number of subjects (34.1%) had experienced a fall at least once within the last six months. Living arrangements, strokes, urinary incontinence, main daily activities, and depression were significant factors related to these falls. Other risk factors included heavy use of medications, difficulties in walking and standing, needing arms to stand up from a chair, and hearing loss. Conclusion: The results reveal critical factors related to falls among the community-dwelling elderly. These information should be used to develop and implement fall prevention programs in communities.

Study on Fall Protection from Scaffolds by Plastic Sheets

  • Ohdo, Katsutoshi;Takanashi, Seiji;Hino, Yasumichi;Takahashi, Hiroki;Toyosawa, Yasuo
    • International Journal of Safety
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    • v.10 no.1
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    • pp.10-15
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    • 2011
  • In Japan, protective measures to reduce falls from scaffolds have been strictly applied within industry safety guidelines, and such measures have significantly decreased fatal accidents due to falls from scaffolds. However, the rate of fatal accidents from falls is still high in the construction industries. In order to examine further countermeasures to reduce such falls, the Japan Ministry of Health, Labour and Welfare established a committee in our institute. That committee$\acute{i}$s work experimentally confirmed the effectiveness of using plastic sheets as a covering around scaffolds to protect against falls of construction materials (a method widely used in Japan). However, the workers fell from the space between the work platform and the plastic sheets very occasionally. Based on those results, the plastic sheets were improved for fall protection from the space, and the effect of the improved sheets was confirmed experimentally.

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