降低內科住院老人跌倒發生率改善方案

Reducing the Incidence of Falls Among the Hospitalized Elderly

陳玉芳(Yu-Fang Chen) ； 高美錦(Mei-Chin Kao) ； 蔡淑妙(Shu-Miao Tsai)

《馬偕護理雜誌》 11卷1期 (2017/01) Pp. 29-41

https://doi.org/10.29415/JMKN.201701_11(1).0003

摘要

老年病人常因體力及下肢肌肉力量減弱、併用多種易跌藥物等因素，造成跌倒傷害。本專案為降低內科住院老人跌倒發生率，經現況分析發現導致本單位跌倒發生率高的原因為：一、病人因年齡、身體虛弱、下肢肌力與活動力差，且不知本身為高危險群執意下床；二、護理人員對跌倒評估流程及預防跌倒作業指引不清楚，缺乏教育訓練課程；三、無監測及審查標準。改善方案：透過設計防跌快篩、修訂預防跌倒評估流程圖、製作預防跌倒及肌力訓練衛教手冊、制定下肢肌力訓練運動、舉辦團體衛教及預防跌倒在職教育、制定審查辦法等方案介入，跌倒率由0.08%降至0.05%。預防高危險病人跌倒措施正確率由82.7%提昇至97.3%，預防跌倒護理指導完整率由44.09%提昇至94.1%，團體衛教滿意度平均為84.5%。

關鍵字

老年病人 ； 跌倒 ； 下肢肌肉力量

並列摘要

Lower physical strength, weakness in limb muscle, and ingesting a variety of drugs prone to falls can result in elderly patients more likely to encounter a fall injury. The project aims to reduce the incidence of falls among the elderly in hospital. Falls occur because of several factors including: 1. age, physical weakness, lower limb muscle weakness, poor activity and lack of insight as high-risk group for falls; 2. nurses may not have a clear understanding of assessment process and prevention guidelines for falls, and may lack of education and training courses in fall prevention; 3. a dearth of monitoring and care review standards. Methods used included fall prevention screening, revised fall prevention assessment flowchart, a production of fall prevention and muscle strength training health education program, conducting a focus-group health education, and the development of fall review standard. The results included a rate of falls has dropped from 0.08 % to 0.05%, the implementation rate of fall precautions for high-risk groups has improved from 82.7% to 97.3%, the completion rate of fall prevention health education has increased from 44.09% to 94.1%, and the satisfaction rate from the focus-groups for the fall prevention education were 84.5%.

並列關鍵字

elderly patients ； fall ； lower limb muscle strength