住院病人跌倒相關因素與管理應用之探討-以某區域教學醫院為例

The Study of the Cause of In-patient Falling down and Its Managerial Application-An Example of a Regional Hospital

王妙娟(Miao-Chuan Wang)

指導教授 ： 鄭 安 欽 ； 賴 志 松

朝陽科技大學/管理學院/企業管理系/碩士(2009年)

摘要

「跌倒」是住院病患常發生之事件，也是重要的病人安全指標之一，對於醫院管理作業具有極為重要之意義。本研究目的在探討住院病人跌倒之屬性、住院病人跌倒原因及確立住院病人跌倒有無傷害性及傷害嚴重度之相關性，採回溯性研究(retrospective study)，以中區某區域教學醫院民國95 年1 月至97 年10 月間院內異常事件通報中有關院內病人跌倒之177筆資料進行分析。
研究結果顯示：跌倒病患的平均年齡為58.16 歲，年紀最小1歲、最大96歲，性別以女性(50.8%)居多，第一次跌倒者佔88.1%，跌倒後之傷害性以無傷害74.0%居多，有傷害佔26.0%；其傷害程度，以第一級傷害（84.8%）居多。發生跌倒前「無預防跌倒收案」佔59.3%，另外跌倒時間以大夜班最多(40.1%)，平時有陪伴者佔50.8%，發生跌倒科別以內科佔47.5%最多，跌倒地點以病人床旁周圍最多佔58.2%，造成病人跌倒可能原因45.2%來自病人健康因素，其次為陪伴者因素佔33.3%。經卡方檢定，病人年齡與跌倒有無傷害及傷害程度有顯著相關，是否跌倒收案對跌倒傷害及傷害程度之影響有顯著差異，跌倒因素中健康、藥物、環境、照顧者、設備等因素與跌倒有無傷害有顯著關係。
本研究結果可提供管理者給予護理人員預防跌倒繼續教育之參考，並落實預防跌倒評估及高危險跌倒病人收案管理，採取適當防範措施，降低跌倒發生率及傷害率，進而確保病人安全並減少健保醫療資源耗用。

關鍵字

傷害性跌倒 ； 跌倒 ； 預防跌倒收案 ； 預防跌倒評估

並列摘要

“Falling down,” a common accident of inpatients, is a target for safety of
patients. This study is a retrospective study in one hospital at Taichung, Taiwan
from January 2006 to October 2008. It analyzed 207 unusual incidents about
falling down of inpatients. After eliminating incomplete data, the left incidents
were 177. The objective of this article was discussion about the types of falling
down, the causes of falling down, and the harms and severity from falling down.
The results of this study showed mean age was 58.16 year-old, the youngest
was 1 year-old, the oldest was 96 year-old. The females were more than
males(50.8%). About 88% patients fell down at the first time. Most of the
accidents didn’t combine other harms(74%). First degree damages were most
which happened in about 85% of the patients. Non-prophylactic patient were
noted about 60%. The accidents were seen during the overnight duty mostly.
About half of the patients had some companies at their bedside. Medical patients
were more than surgical patients. The most sites of falling down were around the
bed. The most causes of falling down were about the health of the patients
(45.2%), and the secondary causes were about their companies(33.3%). The chi
square test for this study showed relationship between the age of the patients and
the harms. Besides, it showed the relationship between prophylactic managements
and the harms. The other causes of falling down were health of the patients, drugs
taken by the patients, environments, and their companies. These results above can
be taken as reference materials for nursing stuff to prevent further accidents.
Carrying out the estimation of falling-down-prophylactic, close observations on
high-probability of falling down, and making appropriate prophylactic measures
can lower the rate and harms from falling-down. Thereby, safety of the patient is
ensured and the resources of medicine can be preserve.

並列關鍵字

falls injury ； falling down ； evaluation of prophylactic falling-down ； case management of prophylactic falling-down

參考文獻

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