Journal List > J Korean Acad Nurs > v.38(5) > 1002478

Kim, Lee, and Eom: Falls Risk Factors of Inpatients

Abstract

Purpose

The purpose of this study was to identify the risk factors for falls and to suggest data for developing a program for preventing falls.

Methods

This was a case-control study in five university hospitals and a general hospital. In total, 216 patients over the age of 18 yr admitted from January 1 to December 31, 2007 participated. One hundred eight patients with experience of falling were matched by gender, age level, diagnosis, and length of stay with 108 patents with no experience of falling admitted on the same unit. A quality assurance coordinator nurse in each hospital examined 35 fall risk factors developed by researchers.

Results

In acute hospitals, history of falls, orientation ability, dizziness or vertigo, general weakness, urination problems, transfer/mobility difficulty, walking dependency, impatience, benzodiazepines, diuretics, and vasodilators showed significance on adjusted-odds ratios for fall. Logistic regression analysis was performed to elucidate the factors that influence falls. The probability of falls was increased by dizziness/vertigo, general weakness, and impatience/agitation.

Conclusion

This finding can be used as a useful resource in developing nursing intervention programs to predict and prevent the falls of inpatients.

Figures and Tables

Table 1
Homogeneity Test between Fallers and Nonfallers (N=216)
jkan-38-676-i001

LOS=length of stay.

Table 2
Odds Ratios between Fallers and Nonfallers by General Characteristics, Physical Status, and Cognitive and Emotional Condition of Subjects (N=216)
jkan-38-676-i002

CI=confidence interval.

Table 3
Odds Ratios between Fallers and Nonfallers by Medication (N=216)
jkan-38-676-i003

CI=confidence interval.

Table 4
Logistic Regression Analysis of Risk Factors Related to Falls (N=216)
jkan-38-676-i004

CI=confidence interval.

Notes

This study was supported by 2006 Eulji Research Grant.

References

1. Aizen E, Shugaev I, Lenger R. Risk factors and characteristics of falls during inpatient rehabilitation of elderly patients. Archives of Gerontology and Geriatrics. 2006. 44:1–12.
2. American Nurses Association. Nursing-sensitive indicators. 2008. Retrieved July 21, 2008. from http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/PatientSafetyQuality/NDNQI/NDNQI_/NursingSensitiveIndicators.aspx .
3. Bergland A, Wyller TB. Risk factors for serious fall related injury in elderly women living at home. Injury Prevention. 2004. 10:308–313.
4. Chaimowicz F, Ferreira Tde.J, Miguel DF. Use of psychoactive drugs and related falls among older people living in a community in Brazil. Revista de Saúde Pública. 2000. 34:631–635.
5. Chen JS, March LM, Schwarz J, Zochling J, Makaroff J, Sitoh YY, et al. A multivariate regression model predicted falls in residents living in intermediate hostel care. Journal of Clinical Epidemiology. 2005. 58:503–508.
6. Cho JP, Paek KW, Song HJ, Jung YS, Moon HW. Prevalence and associated factors of falls in the elderly community. Korean Journal of Preventive Medicine. 2001. 34:47–54.
7. Daal JO, van Lieshout JJ. Falls and medications in the elderly. The Netherlands Journal of Medicine. 2005. 63:91–96.
8. Evans D, Hodgkinson B, Lambert L, Wood J. Falls risk factors in the hospital setting: A systematic review. International Journal of Nursing Practice. 2001. 7:38–45.
9. Fehring RJ. Methods to validate nursing diagnosis. Heart & Lung. 1987. 16:625–629.
10. Gu MO, Jeon MY, Kim HJ, Eun Y. A review of exercise interventions for fall prevention in the elderly. Journal of Korean Academy of Nursing. 2005. 35:1101–1112.
11. Gyldenvand T. Falls: the construction and validation of the risk assessment for fall scale II (RAFS II). 1984. Iowa, USA: University of Iowa;Unpublished master's thesis.
12. Harwood RH. Visual problems and falls. Age and Ageing. 2001. 30:S13–S18.
13. Hendrich A, Nyhuis A, Kippenbrock T, Soja ME. Hospital falls: Development of a predictive model for clinical practice. Applied Nursing Research. 1995. 8:129–139.
14. Hendrich AL, Bender PS, Nyhuis A. Validation of the Hendrich II fall risk model: A large concurrent case/control study of hospitalized patients. Applied Nursing Research. 2003. 16:9–21.
15. Houghton S, Birks V, Whitehead CH, Crotty M. Experience of a falls and injuries risk assessment clinic. Australian Health Review. 2004. 28:374–381.
16. Kim CG. An analysis of fall incidence rate and the related factors of fall in hospitalized patients. 2003. Seoul: Seoul National University;Unpublished master's thesis.
17. Kim EA, Mordiffi SZ, Bee WH, Devi K, Evans D. Evaluation of three fall-risk assessment tools in an acute care setting. Journal of Advanced Nursing. 2007. 60:427–435.
18. Kwon IG, Kim KH. A study on the variables forecasting elderly inpatients' fall experience. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 2007. 16:59–68.
19. Lee HS. A study on fall accident. 1997. Seoul: Seoul National University;Unpublished master's thesis.
20. Morse JM. Preventing patient falls. 1997. Thousand Oaks, CA: Sage.
21. Neyens JC, Dijcks BP, van Haastregt JC, de Witte LP, van den Heuvel WJ, Crebolder HF, et al. The development of a multidisciplinary fall risk evaluation tool for demented nursing home patients in the Netherlands. BMC Public Health. 2006. 6:74.
22. Oliver D, Britton M, Seed P, Martin FC, Hopper AH. Development and evaluation of evidence based assessment tool (STRATIFY) to predict which elderly inpatients will fall: Case-control and cohort studies. British Medical Journal. 1997. 315:1049–1053.
23. Oliver D, Daly F, Martin FC, McMurdo ME. Risk factors and risk assessment tools for falls in hospital inpatients: A systematic review. Age and Ageing. 2004. 33:122–130.
24. Ruthazer R, Lipsitz LA. Antidepressants and falls among elderly people in long term care. American Journal of Public Health. 1993. 83:746–749.
25. Shin KR, Shin SJ, Kim JS, Kim JY. The effects of fall prevention program on knowledge, self-efficacy, and preventive activity related to fall, and depression of low-income elderly women. Journal of Korean Academy of Nursing. 2005. 35:104–112.
26. Sohng KY, Moon JS, Lee KS. Prevalence and associated factors of falls among people with Parkinson's disease. Journal of Korean Academy of Nursing. 2004. 34:1081–1091.
27. Song KA, Moon JS, Kang SS, Choi JH. Activities and fear of falling in the community dwelling elderly. Korean Journal of Public Health Nursing. 2001. 15:324–333.
28. Song KJ, Han MY, Cheong MY, Lim KS, Kim DK. Clinical research design and biostatistical methods. Korean Journal of Urology. 2005. 46:835–841.
29. Tinett ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. New England Journal of Medicine. 1988. 319:1701–1707.
30. Vassallo M, Stockdale R, Sharma JC, Briggs R, Allen S. A comparative study of the use of four fall risk assessment tools on acute medical wards. Journal of the American Geriatrics Society. 2005. 53:1034–1038.
TOOLS
Similar articles