입원 환자의 낙상실태 및 위험요인 조사연구: 국내 500병상 이상 종합병원을 중심으로
Characteristics of Fall Events and Fall Risk Factors among Inpatients in General Hospitals in Korea
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목적 : 본 연구는 종합병원 입원환자의 낙상 현황을 조사하고 국내 병원의 특성을 반영한 낙상 위험요인을 규명하고자 시도되었다. 방법 : 자료수집은 국내 500병상 이상 종합병원 32개를 대상으로 2016년 12월 15일부터 2017년 1월 15일까지 진행되었다. 문헌고찰과 전문가 의견을 토대로 42개의 낙상 위험요인을 추출한 후 각 요인의 중요도를 40개 병원의 내외과계 성인병동 및 중환자실에 근무하는 223명의 간호사를 대상으로 조사하였다. 결과 : 18개 병원에서 보고된 낙상발생률은 입원환자 실인원 1,000명당 3.87건이었고, 연인원 1,000일당 0.55건이었으며 낙상과 관련한 손상률은 40.5 %이었다. 입원환자의 낙상위험 요인 중 65세 이상, 현 입원 중 낙상의 경험, 부분적인 도움이 필요한 신체기동성 장애, 신체적 요인 중 섬망과 자신의 제약에 대한 이해 부족, 질병관련 요인 중 신경계 약물사용이 중요한 요인으로 조사되었다. 결론 : 이 연구 결과는 국내 종합병원 입원환자의 낙상위험 사정도구 개발을 위한 기초자료가 될 것으로 기대된다.
Abstract
Purpose: The purpose of this study was to investigate the present status of falls among inpatients in general hospitals and to identify the fall risk factors that reflect the characteristics of domestic hospitals. Methods: Data were collected between December 15, 2016 and January 15, 2017 from 32 Korean hospitals having 500 or more beds. First, 42 risk factors were extracted based on literature review and expert opinions. Then the importance of each factor was evaluated by 223 nurses from medical and surgical adult ward and intensive care units in 40 hospitals. Results: The incidence rate of falls in 18 hospitals was 3.87 per 1,000 total discharged patients and 0.55 per 1,000 patient-days, and the rate of injury-related falls was 40.5%. Major risk factors for falling were identified as the following: being over 65 years of age, history of falls during admission, physical mobility disorders requiring assistance, physical factors (dizziness or vertigo, unstable gait, general weakness, walking aids, visual problems), cognitive factors (delirium, lack of understanding on limitations), neurological disease, CNS medications Conclusion: The findings provide information that can be in the development of a fall risk assessment tool for inpatients in general hospitals in Korea
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