提升住院高齡長者下床活動率

住院病人以高齡長者居多，因長時間臥床休息，導致肌力、活動功能下降，甚至產生合併症且延長住院天數，故引發改善動機。現況分析單位長者下床活動率僅20.2%，分析主要原因為病人缺乏下床活動動機、病人及照顧者擔心下床危險性且對下床活動認知不足或協助移位技能不足、護理師未主動鼓勵病人多下床活動，設定住院長者下床活動率目標值為60.1%。執行改善對策：制訂高齡長者下床活動常規標準、舉辦在職教育、製作移位圖示卡及衛教手冊、舉辦健康促進團體活動，結果高齡長者下床活動率提升為66.55%，由此得知，藉本專案推動確實可提升住院高齡長者下床活動率進而提升高齡長者醫療照護品質。

關鍵字

高齡病人；下床活動；健康促進

並列摘要

Most hospitalized patients are elderly, and they often spend their time on bed rest during hospitalization. This has resulted in patients losing muscle power and mobility. Aside from that, it has even caused complications and delayed discharge. This project aimed to address this issue. According to our analysis, only 20.2% of elderly inpatients had adequate out-of-bed mobilization. We identified the main causes as follows: 1. The patients lack motivation regarding out-of-bed mobilization; 2. The patients and their caregivers are concerned about the risk of getting out of bed and have insufficient knowledge of out-of-bed mobilization; 3. There is a lack of encouragement from the nurses to get out of bed. Therefore, the purpose of this project was to improve the out-of-bed mobilization rate of elderly patients during hospitalization to 60%. The approaches we adopted were developing a care standard for an out-of-bed mobilization program, holding in-service training, making transfer skill graphic illustration cards and educational pamphlets, and organizing health promotion activities. In doing so, a 66.5% rate of out-of-bed mobilization during the hospitalization of elderly patients was achieved. In conclusion, this project actually enhanced the out-of-bed mobilization rate and improved the healthcare quality during hospitalization.

並列關鍵字

elderly patient ； health promotion ； out-of-bed mobilization

參考文獻

吳麗娟、歐乃欣、劉淑媛、陳佳慧(2012)．住院老年病患之功能下降與其預防．台灣醫學，16 (5)，545-549。https://doi.org/10.6320/F JM. 2012.16(5).11

黃仲禹、黃安君、林明憲(2017)．高齡病患住院醫療．臨床醫學月刊，79 (1)，26-31。https://doi.org/10.6666/ClinMed. 2017.79.1.006

Growdon, M. E., Shorr, R. I., & Inouye, S. K. (2017). The tension between promoting mobility and preventing falls in the hospital. JAMA Internal Medicine, 177(6),759-760. http://doi.org/10.1001/jamainternmed.2017.0840

Hodgson, C. L., Berney, S., Harrold, M., Saxena, M., & Bellomo, R. (2013). Clinical review: Early patient mobilization in the ICU. Critical Care, 17 (1), 207. http://doi.org/10.1186/ cc11820

Hoogerduijn, J. G., Schuurmans, M. J., Duijnstee, M. S., De Rooij, S. E., & Grypdonck, M. F. (2007). A systematic review of predictors and screening instruments to identify older hospitalized patients at risk for functional decline. Journal of Clinical Nursing, 16(1), 46-57. http://doi.org/10.1111/j.1365-2702.2006.01579.x

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