摘要
目的分析老年患者跌倒事件发生的原因、特点、变化趋势和分布特征,为医院制定跌倒伤害预防策略提供参考依据。方法选取2011年1月—2015年12月某三级甲等综合医院通过护理安全(不良)事件上报系统中,老年患者跌倒类护理(安全)不良事件113例,分析患者跌倒发生的时间、地点分布,在不同科室、不同层级护士中的分布,跌倒不良事件发生的主要原因,发生跌倒老年患者的主要诊断疾病种类及损伤结局。结果 113例跌倒老年患者中,夜班发生率占总跌倒事件的69.9%;跌倒地点卫生间发生概率最高,共48例(42.5%);跌倒事件以内科患者最多,79例,占69.9%;涉及护士职称以初级职称为主,占93.8%;护士工作年限<5年者74例(65.5%)。患者跌倒构成比排在前3位的原因分别是:便后体位改变(32.7%)、病情变化(19.5%)、患者自行下床(16.8%)。损失结局中无损伤30例(26.6%)、轻度损伤47例(41.6%)、中度损伤11例(9.7%)、重度损伤24例(21.2%)、死亡1例(0.9%)。结论卫生间地面湿滑、患者体位改变、预防跌倒依从性低、术后或化疗后体质弱及低年资护士风险防范能力不足是患者跌倒的主要原因。护理管理人员需积极引入患者跌倒风险评估表,开展护士预防跌倒相关知识培训,提高护士跌倒评估及健康宣教能力;加强重点时段、重点人群患者及家属的健康教育,针对不同患者采取个体化的跌倒预防措施,提高其预防跌倒依从性及跌倒应对能力。
Objective To analyze the causes, characteristics, trends and distribution characteristics of the falls in elderly patients, to provide reference for taking countermeasures. Methods Totally 113 cases of falls in elderly patients in a Class Ⅲ Grade Ⅰhospital from January 2011 to December 2015 were concluded and the distribution of time, places, nurses, departments, the main causes,diseases causing the falls and the injuries of falls were analyzed. Results Of the total, 69.9% of the cases happened in night shift and most falls（48 cases） happened in toilet, accounting for 42.5%. In terms of the place, most falls（79 cases） occurred in Department of Internal Medicine, accounting for 69.9%. Nurses related to the fall mainly had primary title, accounting for 93.8% and 74 nurses were with working experience shorter than 5 years（65.5%）. Changing body position（32.7%）, progress of the disease（19.5%） and getting out of bed without permission（16.8%） were the top three reasons of falls. There were 30 patients without injury（26.6 %）, 47 with slight physical injury（41.6%）, 11 with moderate injury（9.7%）, 24 with severe injury（21.2%） and 1 died（0.9%）. Conclusion Slippery floor in toilet, changing body position, low adherence with preventing falls of patients, poor health after the operation or chemotherapy and nurses’ low risk prevention ability are the main reason of falls. Nursing managers should actively introduce the assessment table of falls, provide junior nurses with trainings in falls prevention and improve the ability of nurses in assessment and health education. Health education in patients and their families for preventing falling and targeted measures for individuals are effective for preventing falls in elderly patients.
出处
《护理学报》
2017年第17期68-71,共4页
Journal of Nursing（China）
基金
河南省医学科技攻关计划项目(201504H003)
关键词
老年
住院期间
跌倒
原因分析
对策
elderly
be hospitalized
tumble
cause analysis
countermeasure
