Choi Eun Ju, Lee Young Shin, Yang Eun Jung, Kim Ji Hui, Kim Yeon Hee, Park Hyeoun Ae
Department of Nursing, Asan Medical Center, Seoul, Korea.
College of Nursing, Seoul National University, Seoul, Korea.
J Korean Acad Nurs. 2017 Jun;47(3):420-430. doi: 10.4040/jkan.2017.47.3.420.
The aim of this study was to explore characteristics of and risk factors for accidental inpatient falls.
Participants were classified as fallers or non-fallers based on the fall history of inpatients in a tertiary hospital in Seoul between June 2014 and May 2015. Data on falls were obtained from the fall report forms and data on risk factors were obtained from the electronic nursing records. Characteristics of fallers and non-fallers were analyzed using descriptive statistics. Risk factors for falls were identified using univariate analyses and logistic regression analysis.
Average length of stay prior to the fall was 21.52 days and average age of fallers was 61.37 years. Most falls occurred during the night shifts and in the bedroom and were due to sudden leg weakness during ambulation. It was found that gender, BMI, physical problems such elimination, gait, vision and hearing and medications such as sleeping pills, antiarrhythmics, vasodilators, and muscle relaxant were statistically significant factors affecting falls.
The findings show that there are significant risk factors such as BMI and history of surgery which are not part of fall assessment tools. There are also items on fall assessment tools which are not found to be significant such as mental status, emotional unstability, dizziness, and impairment of urination. Therefore, these various risk factors should be examined in the fall risk assessments and these risk factors should be considered in the development of fall assessment tools.
本研究旨在探讨住院患者意外跌倒的特征及危险因素。
根据2014年6月至2015年5月期间首尔一家三级医院住院患者的跌倒史，将参与者分为跌倒者和未跌倒者。跌倒数据来自跌倒报告表，危险因素数据来自电子护理记录。使用描述性统计分析跌倒者和未跌倒者的特征。通过单因素分析和逻辑回归分析确定跌倒的危险因素。
跌倒前的平均住院时间为21.52天，跌倒者的平均年龄为61.37岁。大多数跌倒发生在夜班期间和卧室，原因是行走时突然腿部无力。研究发现，性别、体重指数、身体问题（如排泄、步态、视力和听力）以及药物（如安眠药、抗心律失常药、血管扩张剂和肌肉松弛剂）是影响跌倒的统计学显著因素。
研究结果表明，存在一些重要的危险因素，如体重指数和手术史，这些因素并不在跌倒评估工具范围内。此外，跌倒评估工具中的一些项目，如精神状态、情绪不稳定、头晕和排尿障碍，并未被发现具有显著性。因此，在跌倒风险评估中应检查这些各种危险因素，并且在开发跌倒评估工具时应考虑这些危险因素。
