上海市老年医疗护理机构老年人使用身体约束的现况研究

The using status of physical restraints in the elderly in geriatric care institutions in Shanghai

目的了解上海市老年医疗护理机构身体约束使用现况,探讨使用身体约束的影响因素,为制订适用于老年医疗护理机构的身体约束规范提供参考。方法采用自设量表,对上海市67所老年医疗护理机构及其780名老年人进行调查,并采用Logistic回归分析进行使用身体约束的影响因素分析。结果上海市67所老年医疗护理机构,签署身体约束知情同意书执行率为95.52%、身体约束前评估执行率为34.33%、身体约束护理记录执行率为79.10%;在老年医疗护理机构,影响身体约束使用的影响因素有老年人年龄(OR=2.874,95%CI:2.219~3.723)、性别(OR=4.590,95%CI:0.135~0.350)、跌倒/坠床高危(OR=13.141,95%CI:7.845~22.012)以及管道滑脱高危(OR=4.665,95%CI:2.620~8.304)。结论目前仍需规范上海市老年医疗护理机构身体约束的执行率,提升老年服务内涵质量。

Objective To investigate the using status of physical restraints and explore its influencing factors in geriatric care institutions in Shanghai,to provide reference of stipulate criterions.Methods Using self-designed scale to investigate 67 geriatric care institutions including 780 residents and analyzing the influencing factors by Logistic regression analysis.Results Among 67 geriatric care institutions in Shanghai,the implementation rate of informed consent of physical restraint,pre-use assessment,nursing records were 95.52%,34.33%and 79.10%,respectively.The influencing factors included age(OR=2.874,95%CI:2.219~3.723),gender(OR=4.590,95%CI:0.135~0.350),risk of fall(OR=13.141,95%CI:7.845~22.012)and high risk of tube slip(OR=4.665,95%CI:2.620~8.304).Conclusion At present,it is necessary to standardize the implementation rate of physical constraints in Shanghai geriatric medical care institutions,so as to improve the quality of elderly service connotation.