住院老年痴呆患者安全管理现况调查

An investigation of the current status of safety management in hospitalized elderly patients with dementia

目的:调查分析老年住院痴呆患者安全管理现况,了解住院老年痴呆患者护理中存在的安全管理问题,探索可行的护理干预措施。方法:采用半结构式访谈的方法,由经培训的访谈者访谈7位从事老年护理的专家,并对上海市六家三级医院及一家二级老年护理专科医院,共计300名老年病科及神经内科在职护理人员进行问卷调查。结果:86.60%的护士认为住院老年痴呆患者较其他老年患者存在更多的护理安全问题包括跌倒、误服药、走失、压疮、导管拔除、误吸、自伤、伤人。其中,认为此类患者会发生走失的护士占比达70.79%,误服药63.23%,压疮47.76%,跌倒66.32%,导管拔除63.57%。住院老年痴呆患者目前尚未有专门的问卷及特别标识。专人陪护有助于减少住院老年痴呆患者不安全事件的发生。结论:建立中国老年痴呆患者安全管理模式,是我国老年病科护理人员有待认真探索并努力解决的关键问题。

Objective:To investigate the current status of safety management in hospitalized elderly patients with dementia,safety management issues in nursing of such patients,and feasible nursing intervention measures.Methods:Seven experts engaged in geriatric nursing were interviewed by trained interviewers through semi-structured interviews,and a questionnaire survey was conducted among300 nurses in Department of Geriatrics and Department of Neurology in six tertiary hospitals and one secondary hospital specialized in geriatrics in Shanghai,China.Results:Of all nurses,86.60%thought that hospitalized elderly patients with dementia had more nursing safety issues than other elderly patients,including falls,drug misuse,getting lost,pressure ulcers,accidental extubation,aspiration,self-harm,and hurting other persons.Of all nurses,70.79%believed that such patients might get lost,63.23%thought they might experience drug misuse,47.76%thought they might suffer from pressure ulcer,66.32%thought falls might occur in these patients,and 63.57%thought they might experience accidental extubation.At present,there are no special questionnaires and labels for hospitalized elderly patients with dementia.Specialized caretakers may help to reduce the incidence rates of unsafe incidents in hospitalized elderly patients with dementia.Conclusion:Establishment of a safety management model for hospitalized elderly patients with dementia in China is a key issue which should be taken seriously by nursing staff in Department of Geriatrics.