介護老人保健施設入所者の転倒発生状況:― 移動手段に着目して ―  [in Japanese] Fall Occurrence in Long-term Care Facilities:― A Focus on the Movement Status of Residents ―  [in Japanese]

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Author(s)

    • 巻 直樹 MAKI Naoki
    • 筑波大学大学院人間総合科学研究科 Graduate School of Comprehensive Human Science, University of Tsukuba
    • 稲田 晴彦 INADA Haruhiko
    • 筑波大学医学医療系福祉医療学 Department of Medical Science and Welfare, Faculty of Medicine, University of Tsukuba
    • 奥野 純子 OKUNO Junko
    • 筑波大学医学医療系福祉医療学 Department of Medical Science and Welfare, Faculty of Medicine, University of Tsukuba
    • 柳 久子 YANAGI Hisako
    • 筑波大学医学医療系福祉医療学 Department of Medical Science and Welfare, Faculty of Medicine, University of Tsukuba

Abstract

【目的】本研究は,施設入所者を車いす使用者(全介助者)・車いす使用者(部分介助者)・歩行移動者に分類し,移動手段別に転倒発生状況を明らかにすることを目的とした。【方法】3 か所の介護施設において,過去1 年間の事故報告書などを分析対象とした。対象者数は341 名(A 施設86名,B 施設113 名,C 施設142 名),移動手段別に車いす使用者(全介助者)・車いす使用者(部分介助者)・歩行移動者に分類し,転倒件数,転倒者数,転倒場所,転倒時間帯,転倒様式について分析した。また,移動手段別の転倒発生割合(移動手段別転倒者数/移動手段別入所者総数),および1,000 人日当たりの発生頻度を求めた。【結果】施設全体の事故報告件数459 件のうち転倒件数は304 件(66 %)であり,転倒者数は341 名のうち154 名(45 %),1,000 人日当たり1.6 であった。移動手段別に見ると,車いす使用者(全介助者)は,80 名中15 名(19 %,0.1/1,000 人日)が転倒しており,転倒件数43 件であった。転倒場所は居室・食堂・ホール38 件(88 %),転倒時間帯は午後2 時~ 4 時で12 件(28 %),転倒様式は介護者に由来する転落やずり落ちが16 件(37 %)とそれぞれ最も多く報告された。車いす使用者(部分介助者)は,200 名中113 名(57 %,1.2/1,000 人日)が転倒しており,転倒件数208 件であった。転倒場所は居室126 件(61 %),転倒時間帯は午後2 時~ 4 時で31 件(15 %),転倒様式は本人に由来する移乗時の転倒が94 件(45 %)とそれぞれ最も多く報告された。歩行移動者は,61 名中26 名(43 %,0.3/1,000 人日)が転倒しており,転倒件数53 件であった。転倒場所は居室22 件(42 %),転倒時間帯は午前6 時~8 時で7 件(13 %),転倒様式は歩行時の転倒が32 件(60 %)とそれぞれ最も多く報告された。【結論】事故報告総数の60 %以上が転倒事故であり,施設全体の年間転倒発生割合は45 %と過去の報告と同程度であったが,移動手段別に見ると,それぞれの転倒発生状況および転倒発生割合は異なっていた。

【Objective】To analyze the conditions of the falls according to the movement status of residents in long-term care facilities.【Methods】Incident reports from April 2013 to March 2014 in three long-term care facilities in Ibaraki Prefecture, Japan, were analyzed. Facility residents were classified into three groups according to movement status; totally cared wheelchair users, partially cared wheelchair users, or walkers. The location, time, and manner of the falls according to movement status were analyzed.【Results】Out of the 341 residents, 154 residents experienced falls during the one-year period. The total fall rate was 45%, 1.6/1,000 person-days; however, fall occurrences were different for each movement status; the totally cared wheelchair users was 19%, 0.1/1,000person-years; the partially cared wheelchair users was 57%, 1.2/1,000 person-years, and the walkers was 43%, 0.3/1,000 person-days. Regarding the location of the falls, the totally cared wheelchair users were most likely to fall in their bedrooms, dining room, and public spaces, and the partially cared wheelchair users and walkers were most likely to fall in their bedrooms. Both groups of wheelchair users were most likely to fall between 2:00 p.m. and 4:00 p.m., while most walkers experienced falls between 6:00 a.m. and 8:00 a.m. Regarding the manner of the falls, the totally cared wheelchair users were most likely to fall during care from caregivers, the partially cared wheelchair users were most likely to fall during transfer by themselves, and the walkers were most likely to fall during walking.【Conclusion】The occurrence rate and conditions of the falls differed according to the movement status of the residents. Taking movement status into account when designing fall prevention plans may help reduce the number of falls.

Journal

  • JapaneseJournal of Fall Prevention

    JapaneseJournal of Fall Prevention 2(3), 23-32, 2016

    The Japanese Society for Fall Prevention

Codes

  • NII Article ID (NAID)
    130005159249
  • NII NACSIS-CAT ID (NCID)
    AA12705927
  • Text Lang
    JPN
  • ISSN
    2188-5702
  • NDL Article ID
    027267415
  • NDL Call No.
    Z74-J288
  • Data Source
    NDL  J-STAGE 
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