住院老年人跌倒的预防教育

Health education on preventing senile inpatients from tumble

目的了解医院内老年人跌倒的状况，以更有效地进行预防跌倒的教育。方法以查阅病历、访谈和实地观察跌倒环境获取资料，回顾分析1995～2004年在住院期间发生跌倒的老年人共40例。描述跌倒者的年龄、原有疾病、跌倒发生时间的分布，以厦当时是否有人在场、跌倒地点、跌倒与活动的关系等。结果跌倒者以高龄老人居多，老年痴呆、老年精神病、脑梗塞者较多；均发生在室内，在患者独处时发生；跌倒与活动密切相关。无论是否有肢体活动不便，能否自行活动，老年人均存在跌倒的危险。跌倒不仅发生在活动频繁的日间，夜间跌倒例数几乎与日间相同。跌倒后绝大部分发生不同程度损伤。结论老年人群是发生跌倒的高危人群，尤其是高龄老年人；预防教育需在对老年人反复强化教育的基础上，对他们的照护者加强教育；为减少老年人跌倒的发生，应在保持老年人自主能动性的前提下，适量限制老年人、特别是高龄老人的活动范围。老年人的居住休养环境应更适合老年人活动的需要，安装安全设施。对缺乏依从性的老年人应要求其签署跌倒发生危险的知情同意书，以避免不必要的医疗护理纠纷。

Objective To understand the situation of senile inpatients＇ tumble in order to imple ment health education on tumble prevention more effectively. Methods 40 senile inpatients who occurred tumble in 1995-2004 were investigated respectively by reading medical records, interview and on--the --spot observation. Results The elderly inpatients who were more than 80 years old occur tumble frequently, so were the senile inpatients with senile dementia, psychosis, cerebral--vascular disease. The tumble occurred indoor when the patient was alone and had close relationship with moving. Senile inpatients had the risk of tumble regardless of that they had motive ability or not. The incidence of tumble in day was the same as that in night. Most of the patients with falls had damage in varying degrees. Conclusions Senile inpatients are the people that have high--risk of tumble. We should strengthen preventive health education of their caregivers on the base of educating senile inpatients repeatedly. Restricting their moving scope properly is necessary in order to prevent their tumble, but their moving abilities should be kept. The related environmental factors should be suitable for senile persons. In the senile persons with less compliance, we should ask for them signing the paper in order to make sure that they and their caregivers know the risk of tumble.