住院病人跌倒率的前瞻性研究

Prospective study on the incidence rate of inpatients' fall

目的:了解住院病人跌倒发生情况,为跌倒的科学管理提供依据。方法:采用自行设计的表格,由经过培训的实习护生对住院病人及其家属在规定的时间内进行访谈,收集病人发生跌倒的相关情况;共访谈2585例病人(或家属)。结果:①所调查的病人中,住院期间28例病人至少发生1次跌倒,其中2例有2次跌倒,跌倒率为1.08%或每天0.84次/1000病人。②跌倒病人特征:老年科跌倒率最高为7.5%,其次为内科1.27%;跌倒病人年龄显著高于未跌倒病人;跌倒主要发生在病室内(40.0%)和卫生间内(40.0%);绝大部分病人在下床时(63.3%)和行走时(30.0%)跌倒;跌倒时间以白天为主(79.3%);6例跌倒病人入院时跌倒风险评估为阴性;跌倒所致的后果较轻,25例次病人无伤害发生,4例次发生软组织损伤,1例次骨折,均无纠纷。结论:与国际报道相比,病人跌倒率处于较低水平,但须加强老年科病人和全院各科老年病人跌倒的预防,跌倒预防对象应扩展到全体住院病人。

Objective： The aim of the study was to investigate the occurrence of inpatients＇ fall, in order to provide the basis for scientific management. Methods： The nursing students who had received relating trainings had interviews with 2585 inpatients and their family members using a self-design interview guideline at specified times. Results： ① There were 28 inpatients having fallen at least once during hospitalization and two of them felling twice with the incidence offaU was 1.08% or 0.84 per 1000 patients every day; ② The highest fall incidence among geriatric patients was 7.5% of, followed by 1.27% （patient in internal medical departments）. Older patients were more likely having experiences of falling. Falling mainly happened in wards （40%） and bathroom （40%）, when getting out of bed （63.3%）, walking went on foot （30%）, during daytime （79.3%）. There were 6 patients having negative fall risk assessment on admission, 25 patients without injury, 4 with soft tissue injury and 1 having fracture （no dispute）. Conclusion： Compared with the findings in other countries, the rate of patients fall was at a low level. It is suggested to strengthen the prevention of geriatric patients and all elderly patients in the hospital, and the targets patients of fall prevention should be extended to all inpatients.