title: Falls, Balance Confidence, and Lower-Body Strength in Patients Seeking Outpatient Venous Ulcer Wound Care.
abstract: To provide information about a quality improvement project examining falls in persons seeking outpatient wound care.
  
  
  BACKGROUND
  This continuing education activity is intended for physicians and nurses with an interest in skin and wound care.
  
  
  OBJECTIVE
  After participating in this educational activity, the participant should be better able to:1. Describe the scope of the problem and the related quality improvement project. 2. Delineate the results of the project and their implications for treatment of patients with venous ulcers.
  
  
  OBJECTIVE
  The authors aim to examine fall occurrence and fall injuries in persons seeking outpatient wound care and to compare falls, balance confidence, and lower-body strength in persons with injection-related venous ulcers (IRVUs) versus persons with venous ulcers (VUs) related to other risk factors besides injection drugs (VUs-other).
  
  
  METHODS
  This quality improvement project used a cross-sectional, comparative design. Participants responded to demographic questions, the Activities-specific Balance Confidence (ABC) Scale, fear of falling, fall numbers, and injuries and performed the 30-second chair-rise test.
  
  
  METHODS
  Outpatient wound service.
  
  
  METHODS
  Patients (N = 106; mean age, 59.94 years) included men (66%) and women.
  
  
  RESULTS
  Sixty patients reported falling; 47 were recurrent fallers. Twenty patients stated they were injured, but did not go to an emergency department. A higher number of total falls was significantly related to more comorbidities. Total falls were significantly related to fear of falling and ABC Scale scores. Those with VUs-other had significantly more comorbidities and higher body mass index values than those with IRVUs. Those with IRVUs were comparable to those VUs-other on number of falls and fear of falling, respectively. Those with IRVUs (7.30) performed significantly more chair rises than those with VUs-other (4.72). Persons with IRVUs had significantly higher ABC Scale scores (63.24%) than those with VUs-other (49.38%).
  
  
  CONCLUSIONS
  Falls are a common occurrence in persons seeking outpatient wound care. Despite greater strength sufficient to perform more chair rises among those with IRVUs, fall rates were comparable to those of weaker individuals with other types of VUs. With the high occurrence of falls during the project, long-term risk for fall injury would be high. Further research is needed to clarify interactions between VU risk and patient factors such as strength, age, agility, and impaired cognition.
authors.affiliation: Barbara Pieper, PhD, RN, CWOCN, ACNS-BC, FAAN • Professor/Nurse Practitioner • College of Nursing, Wayne State University • Detroit, Michigan Thomas N. Templin, PhD • Professor • Office for Health Research, College of Nursing, Wayne State University • Detroit, Michigan.
authors.forename: Barbara
authors.initials: B
authors.lastname: Pieper
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Templin
mesh_terms: D000058:Accidental Falls; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010342:Patient Acceptance of Health Care; D004856:Postural Balance; D012649:Self Concept; D014647:Varicose Ulcer / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy