한국전자통신학회논문지 (The Journal of the Korea institute of electronic communication sciences)

한국전자통신학회 (Korea Institute of Electronic Communication Science)
권호 표지
DOI QR코드

DOI QR Code

영상처리 기반 재활 환자의 헬스케어 개선을 위한 낙상예방 프로그램 개발 : 예비연구

Development of Fall Prevention Program for Improvement of Healthcare in Rehabilitation Patients Based on Image Processing : A Preliminary Investigation

  • 강소라 (인천사랑병원 재활의학과 작업치료실) ;
  • 윤중대 (인천사랑병원 재활의학과 물리치료실) ;
  • 유진원 (인천사랑병원 재활의학과 물리치료실) ;
  • 나창호 (인천 글로리 병원 작업치료실) ;
  • 허성진 (양산부산대학교병원 의생명융합연구소) ;
  • 김예순 (국립재활원 재활연구소 건강보건연구과) ;
  • 문종훈 (국립재활원 재활연구소 건강보건연구과)
  • 투고 : 2017.12.05
  • 심사 : 2018.08.15
  • 발행 : 2018.08.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

본 예비연구는 낙상예방 프로그램이 종합병원 입원환자의 낙상발생에 미치는 영향을 조사하고자 하였다. 중재 전, 인천에 위치한 I병원에 입원하여 재활치료를 받는 환자 190명의 낙상발생빈도를 확인하였다. 낙상의 원인은 환자 보호자 및 치료사의 부주의, 치료사의 업무 부담의 가중, 침상의 높이, 보호자의 부재와 같은 치료실 환경의 문제로 나타났다. 저자들은 PDCA 모델을 통하여 문제점을 인식한 후 낙상예방 프로그램을 개발하였다. 낙상예방 프로그램의 구성은 낙상예방교육 동영상을 제작하여 환자 및 보호자에게 교육하였고, 환경개선 및 치료사교육을 2개월 간 수행하였다. 중재 후, 낙상 발생률의 분석은 220명의 환자를 대상으로 하였다. 그 결과, 낙상발생률은 중재 전과 비교하여 통증치료실은 34.1~66.7%가 줄었으며, 운동/작업치료실은 21.3~40.8%가 감소하였다. 본 연구의 결과는 낙상예방 프로그램이 입원환자의 낙상 감소에 긍정적인 효과를 나타내고 있으며, 낙상예방 모델 중 하나의 방법이 될 것이다.

The purpose of this preliminary study was to investigate the effect of fall prevention program on the occurrence of falls in inpatients at general hospital. Before the intervention, we identified the occurrence of the rate of falls in I hospital at Incheon and 190 patients received rehabilitation treatment. The causes of falls were carelessness of caregivers and therapists, increased burden of therapists, and height of beds. After recognizing the problems, the authors developed a fall prevention program through the PDCA model. The fall prevention program consisted of a video of fall prevention education and education for the patients and caregivers, environmental improvement and education of therapists for two months. After intervention, 230 patients were subjected to be included as analysis of the incidence of falls included As a result, the fall incidence was reduced by 34.1~66.7% in the pain clinic and 21.3~40.8% in the exercise clinic / department of occupational therapy compared to the before intervention. These findings show that the fall prevention program has a positive effect on the fall of inpatients, and it can be used as a model for fall prevention.

키워드

참고문헌

  1. A. B-A. Sari, T. A. Sheldon, A. Cracknell, and A. Turnbull, "Sensitivity of routine system for reporting patient safety incidents in an NHS hospital: retrospective patient case note review," BMJ, 2017, vol. 334, no. 7584, pp. 79-86. https://doi.org/10.1136/bmj.39031.507153.AE
  2. U. Beckmann, D. M. Gillies, S, M. Berenholtz, A. W. Wu, and P. Pronovost, "Incidents relating to the intra-hospital transfer of critically ill patients," Intensive care medicine, 2004, vol. 30, no. 8, pp. 1579-1585. https://doi.org/10.1007/s00134-004-2177-9
  3. C. Kim. "An analysis of fall incidence rate and the related factors of fall in hospitalized patients," Korean J. of Quality in health care, 2002, vol. 9, no. 2, pp. 210-228.
  4. D. Oliver, A. Hopper, and P. Seed, "Do hospital fall prevention programs work? A systematic review," J. of the American Geriatrics Society, 2000, vol. 48, no. 12, pp. 1679-1689. https://doi.org/10.1111/j.1532-5415.2000.tb03883.x
  5. S. Kim and Y. Lee, "Falls Risk Factors of Elderly Inpatients," J. of the Korean Data Analysis Society, 2014, vol. 16, no. 4, pp. 2191-2203.
  6. S. Kim, "Factors Related to the Awfulness of Fall Among the Elderly Inpatients in a General Hospital," Master's Thesis, Chungnam National University, 2009.
  7. M. Han, "A Study on the Safety Training of Inpatient in a Hospital-Focused on Fall Accident-," Master's Thesis, Soonchunhyang University, 2014.
  8. M. Kim, "Factors associated with falls in the elderly : based on 2014 the Korean elderly survey," The J. of the Korea Contents Association, 2017, vol. 17, no. 6, pp. 479-489. https://doi.org/10.5392/JKCA.2017.17.06.479
  9. I. D. Cameron, G. R. Murray, L. D. Gillespie, M. C. Robertson, K. D. Hill, R. G. Cumming, and N . Kerse. "Interventions for preventing falls in older people in nursing care facilities and hospitals," Cochrane Database Systemic Review, 2010, vol. 1, no. 1, pp. 213-289.
  10. A. Jeon, J. Yoo, G. Park, and G. Jeon, "Implementation of Falls Detection System Using 3-axial Accelerometer Sensor," J. of Korea Academia-Industrial cooperation Society, 2011, vol. 11, no. 5, pp. 1564-1572. https://doi.org/10.5762/KAIS.2010.11.5.1564
  11. S. Kim, J. Ahn, and W. Kim, "Implementation of fall-down detection algorithm based on Image Processing," J. of Satellite, Information and Communications, 2017, vol. 12, no. 2, pp. 56-60.
  12. T. Kim, "Smartphone based fall detection system applying the fall direction," Master's Thesis, Korea University, 2015.
  13. J. Moon and Y. Won, "Effects of Cognitive Training Using Tablet PC Applications on Cognitive Function, Daily Living and Satisfaction in Subacute Stroke Patients," J. of the Korea Institute of Electronic Communication Sciences, vol. 12, no. 1, 2017, pp. 219-228. https://doi.org/10.13067/JKIECS.2017.12.1.219
  14. J. Moon and Y. Won, "Effects of orofacial exercises training program using smart phone on swallowing function and tongue strength in acute stroke patients with dysphasia," J. of the Korea Institute of Electronic Communication Sciences, vol. 11, no. 10, 2016, pp. 995-1002. https://doi.org/10.13067/JKIECS.2016.11.10.995
  15. J. Moon and I. Park, "The Effects of Self-Exercise Based on Health Care Application on Upper Extremity Function and Daily Living, Satisfaction in Patients with Stroke," J. of the Korea Institute of Electronic Communication Sciences, vol. 12, no. 3, 2017, pp. 515-524. https://doi.org/10.13067/JKIECS.2017.12.3.515
  16. B. Fisher and K. Sullivan, "Activity-dependent factors affecting poststroke functional outcomes," Topics in stroke rehabilitation, 2001, vol. 8, no. 3, pp. 31-44. https://doi.org/10.1310/B3JD-NML4-V1FB-5YHG
  17. M. J. Faber, R. J. Bosscher, M. J. C. A. Paw, and van P. C. Wieringen. "Effects of exercise programs on falls and mobility in frail and pre-frail older adults: a multicenter randomized controlled trial," Archives of physical medicine and rehabilitation, 2006, vol. 87, no. 7, pp. 885-896. https://doi.org/10.1016/j.apmr.2006.04.005
  18. R. Teasell, M. McRae, N. Foley, and A. Bhardwaj, "The incidence and consequences of falls in stroke patients during inpatient rehabilitation: factors associated with high risk," Archives of physical medicine and rehabilitation, 2002, vol. 83, no. 3, pp. 329-333. https://doi.org/10.1053/apmr.2002.29623
  19. Y. Park, M. Lee, and S. Jung, "Development of QI Activity Evaluation Framework Based on PDCA and Case Study on Quality Improvement Activities," J. of Korean Academy of Nursing Administration, 2012, vol. 18, no. 2, pp. 222-233. https://doi.org/10.11111/jkana.2012.18.2.222
  20. Y. Lee and M. Gu, "Circumstances, Risk Factors, and the Predictors of Falls among Patients in the Small and Medium-sized Hospitals," J. of Korean Clinical Nursing Research, 2015, vol. 21, no. 2, pp. 252-265. https://doi.org/10.22650/JKCNR.2015.21.2.252
  21. R. Ruchinskas, "Clinical prediction of falls in the elderly," American J. of Physical Medicine and Rehabilitation, 2003, vol. 82, no. 12, pp. 273-278.
  22. M. Tinetti and M. Speechley, "Prevention of falls among elderly," The New England J. of Medicine, 1989, vol. 320, no. 16, pp. 1055-1059. https://doi.org/10.1056/NEJM198904203201606