運用多重因子介入策略降低住院病人傷害性跌倒發生率

Implementation of Multi-Factor Interventions in Reducing the Incidence of Falls in Hospitalized Patients

邱燕甘(Yen-Gan Chiou) ； 戴雪玲(Hsueh-Ling Tai) ； 楊佩欣(Pei-Hsin Yang)

《志為護理-慈濟護理雜誌》 20卷2期 (2021/04) Pp. 75-86

摘要

醫院跌倒事件不僅影響病人健康，也會增加醫療人員的心理壓力。本專案旨在運用多重因子介入策略降低住院病人傷害性跌倒之發生率，經現況分析確立主要問題為：高危病人低估自己跌倒的風險、護理人員執行預防跌倒作業正確率偏低、缺乏跨團隊預防跌倒合作機制及欠缺多重因子介入措施。擬定各項解決對策：規劃教育訓練課程、設計多種衛教工具及增加高危病人標示、拍攝床上復健運動、增加輔助設備、建置日常化管理制度、建置多重用藥資訊化提示。經實施後，六個病房的傷害性跌倒由改善前11件（0.014%）降至5件（0.012%），傷害比率由91.7%降至62.5%，重度跌倒降至0件。建議可平行推展至全院各單位，營造病人安全的照護環境。

關鍵字

病人安全 ； 預防跌倒 ； 住院病人 ； 多重因子介入

並列摘要

Falls in hospitals not only affect the health of patients but also increase the stress of healthcare professionals. This study aims to reduce the incidence of falls among hospitalized patients by using multi-factor interventions. The main problems identified by the current situation analysis were inadequate assessment, inappropriate actions, and lack of teamwork among healthcare professionals in the prevention of falls. The interventions done to decrease the risk of falls are the following: Planning training courses, designing health education tools, increasing the labeling techniques for high-risk patients, recording videos of rehabilitation exercises performed on bed, adding facilitation materials, establishing a daily management system, and improving on reminding patients taking multiple medications. The results showed that the fall incidence rate decreased from 11 (0.014%) to 5 (0.012%), the injury rate decreased from 91.7% to 62.5%, and no severe fall accident occurred. The implementation of multifactor interventions should be extended to all units to create a safer environment for patients.

並列關鍵字

fall prevention ； hospitalized patients ； multiple factor intervention ； patient safety

參考文獻

朱月英、賴琬姿、蔡宛庭、吳姿瑤、溫雁凱(2014)．住院病人跌倒發生率改善專案．榮總護理，31 (3)，234-243。http://doi.org/10.6142/VGHN. 31.3.234

李鴻春、蔡芳文、林惠如、劉介宇、謝佳容(2018)．長期照護機構老人的身體平衡功能與跌倒發生的前瞻性研究，新臺北護理期刊，20 (1)，11-25。http://doi.org/10.6540/NTJN.2018.1.002

周小玉、沈怡君、吳徐慧(2019)．運用多元化策略降低內科住院病人跌倒發生率，長期照護雜誌，23(3)，203-215。http://doi.org/10.6317/LTC.201912_23(3).0004

陳怡君、顏妙芬(2017)．探討住院病人跌倒傷害的危險因子，醫務管理期刊，18 (2)，124-143。http://doi.org/10.6174/JHM2017.18(2).124

黃素妃、楊婷婷、陳雪芬、呂莉婷、廖容瑜(2018)．預防計畫對於老人跌倒相關傷害之成效：統合分析，教育科學研究期刊，63 (2)，163-186。http://doi.org/10.6209/JORIES.201806_63(2).0007