精神科急性病房預防跌倒改善專案

A Project to Reduce Falls in an Acute Psychiatric Ward

蔡佳吟(Chia-Yin Tsai) ； 侯淑英(Shu-Ying Hou)

《精神衛生護理雜誌》 5卷1期 (2010/10) Pp. 29-39

https://doi.org/10.6847/TJPMHN.201010_5(1).0004

摘要

本專案目的為降低住院病人跌倒率。統計南區某醫學中心精神科急性病房2008年7月1日至11月30日共19件跌倒事件，平均跌倒率0.52%，每月跌倒率皆高於醫院跌倒率閾值0.28%。經由護理、環境、醫療和病人家屬層面分析，發現主要問題為：預防跌倒照護標準執行率偏低(46.98%)、缺乏精神科高危險跌倒因子篩選表及預防跌倒照護標準、環境缺乏安全性設置和病人家屬對預防跌倒照護認知不足。故本小組成員針對以上問題擬定解決方案：設計精神科高危險跌倒因子篩選表、製作預防跌倒照護標準手冊、製訂預防跌倒護理指導記錄單、環境改造和定期舉辦預防跌倒衛教團體。結果平均跌倒率降至0.36%，預防跌倒照護標準執行率提升至93.20%，且增加病患預防跌倒認知及養成病患良好生活習慣，故將此經驗提供精神科急性病房參考。

關鍵字

精神病患 ； 跌倒 ； 照護標準

並列摘要

This project aimed at elevating the rate of implementation of health education and reducing the rate of inpatient falls. Statistics in an acute ward at a medical center in southern Taiwan showed 19 fall incidents from July 1(superscript st) to November 30(superscript th) in 2008. The mean fall rate was 0.52%, which was higher than the fall rate (0.28%) suggested in hospital. Careful analysis of nursing care, environment, medication and patients and families revealed that the main problems were a low rate of implementation rate of health education (46.98%), a lack of high-risk fall factor screening tools for psychiatry departments and standards of care for fall prevention, environmental settlement, and insufficient knowledge among patients and families. The project team established a plan which included design of a high-risk fall factor screening tool, producing pamphlets on standards of care for fall prevention, production of health education record sheets on preventing falls, environment reconstruction, and regular group health education. The results indicated that the health education implementation rate increased to 93.20%, while the fall rate decreased to 0.36%. In addition, patients and families gained greater knowledge about preventing falls, and patients developed better habits of living. This project might in future serve as a reference for nursing staff in acute psychiatric wards.

並列關鍵字

psychiatric patient ； fall prevention ； standard of care