상급종합병원 입원환자의 낙상 후 상해 실태 및 상해에 영향을 미치는 요인
Factors Associated with Injuries after Inpatient Falls in a Tertiary Hospital
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본 연구는 일개 상급종합병원 입원환자의 낙상 후 상해관련 실태를 파악하고, 낙상 후 상해 발생에 영향을 주는 요인을 분석하였다. 서술적 종단적 조사연구로 2015년 1월 1일부터 12월 31일까지 1년간 환자안전보고시스템을 통해 보고된 428건의 전자의무기록 자료를 STATA 13.0으로 서술적 통계 및 다변량 로지스틱 회귀분석을 수행하였다. 연구 결과 197건(46.0%)의 낙상 후 상해가 발생하였고, 119건(27.8%)의 추후 진단적 검사를 시행하였으며, 집중관찰 포함하여 358건(83.6%)의 낙상 관련 치료를 받은 것으로 나타났다. 낙상 후 상해 발생에 유의하게 영향을 미치는 요인으로는 연령, 진료과, 낙상위험요인이었다. 결론적으로 입원환자의 낙상 후 상해 발생을 감소시키기 위해서는 본 연구에서 규명된 낙상 후 상해 영향 요인을 바탕으로 병원 차원의 주기적인 낙상 후 상해 영향요인 평가가 이루어져야하며, 고령 환자를 위한 맞춤형 낙상 예방교육, 운동 프로그램, 이에 대한 피드백 등의 간호활동과 낙상 후 상해가 많이 발생하는 진료과의 환경·시설 개선 및 안전한 보조기(워커 및 휠체어) 사용 권장 등이 필요하겠다.
Abstract
Purpose: In this study an investigation was done of injuries from inpatient falls and diagnostic tests and treatment after falls to identify what factors affect the occurrence of injury from inpatient falls in a tertiary hospital. Methods: Data for this cross-sectional study were retrieved for 428 fall events from data reported between January 1 and December 31, 2015 and were retrieved from the patient-safety reporting system in the hospital’s electronic health records. A multivariate logistic regression model was developed with STATA 13.0. Results: Of the patients, 197 (46.0%) had physical injuries due to falls, 119 (27.8%) were given further diagnostic tests, and 358 (83.6%) received treatment including close observation after inpatient falls. Logistic-regression results identified that age, department, and risk factors had significant impact on injuries from falls. Conclusion: Findings indicate that to reduce the severity of injury after inpatient falls, each hospital should regularly evaluate identified factors, design fall-prevention practices specialized for elders and vulnerable patients, and initiate environmental and equipment innovations.
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