降低精神科慢性病房跌倒發生率

Reduction of Fall Incidents Among Patients in Chronic Psychiatric ward

柯云淇(Yun-Chi Ke) ； 余庭姗(Ting-Shan Yu) ； 高薏茹(Yi-Ju Kao) ； 曾素美(Su-Mei Tseng)

《精神衛生護理雜誌》 17卷1期 (2022/04) Pp. 33-43

https://doi.org/10.6847/TJPMHN.202204_17(1).05

摘要

精神科病人因疾病、長期用抗精神藥物容易發生跌倒，一旦跌倒發生會增加醫療費用及住院天數，甚至醫療糾紛，回溯2018年第四季至2019年第一季跌倒發生率超過本院閾值。經現況分析高跌倒率之原因為：病人缺乏預防跌倒認知、下肢肌肉力量＜5分、「疑似肌少症」、「預防跌倒衛教手冊」內容缺乏專科性且文字多、護理人員預防跌倒作業執行完整率偏低。經文獻查證及小組討論後，擬定解決辦法為：施行防跌團體衛教與宣導海報、提供太極拳訓練運動、修訂符合精神專科特性的「預防跌倒照護手冊」、制定「精神科預防跌倒照護標準」。上述介入後，跌倒發生率由0.131%降為0.00%，達成專案目的，有效維護病人安全及提升照護品質。

關鍵字

跌倒 ； 疑似肌少症 ； 太極拳訓練運動

並列摘要

The nature of psychiatric disorders and long-term antipsychotic use render inpatients with psychiatric disorders vulnerable to falls, and fall-related injuries may result in an increase in medical expenses, hospital days, and even medical disputes. The number of fall incidents from the fourth quarter of 2018 to the first quarter of 2019 exceeded the hospital's threshold. The high fall rate is attributed to the following factors: lack of patient knowledge regarding fall prevention, low lower limb muscle strength, poor balance, and probable sarcopenia. The content of the Fall Prevention Health Education Manual is extensive and not specialized for use with psychiatric inpatients. Moreover, the number of nurses who execute fall prevention operations is inadequate. Based on a literature review and group discussion, the following measures were implemented: (1) Group fall prevention education programs were conducted, and publicity posters were created and hung around the ward. (2) Tai Chi exercise intervention was administered. (3) The content of the Fall Prevention Health Education Manual was revised to include psychiatric specialties. (4) Finally, care standards for fall prevention in psychiatric wards were formulated. The incidence of fall incidents was reduced from 0.131% to 0.00%, thereby effectively maintaining patient safety and improving the quality of care.

並列關鍵字

fall ； probable sarcopenia ； Tai Chi training exercise

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