SDM理念应用于老年骨质疏松患者跌倒风险管理

SDM concept applied to fall risk management in elderly osteoporosis patients

目的探讨应用患者参与医疗决策(shared decision making,SDM)理念,使骨质疏松患者及家属参与跌倒风险评估及防范措施的制订,旨在降低住院患者跌倒发生率。方法2017年1月—2017年12月入院的597例骨质疏松患者为对照组,2018年1月—2018年12月入院的603例骨质疏松患者为干预组。对照组采用传统跌倒风险评估和防范措施,干预组通过运用SDM理念,教会跌倒高危患者及家属正确使用Morse风险评估表,使患者更加清楚自身所在的跌倒风险等级,并不断强化预防跌倒的信念,增加跌倒防范意识,同时与患者及家属共同制订跌倒防范措施。对2组患者院内跌倒发生情况进行比较。结果患者及家属参与跌倒风险评估并共同制订和落实跌倒防范措施,患者住院跌倒发生率较前降低(P<0.05),跌倒中重度损伤的发生例数从2017年的3例降低到2018年的1例。结论应用SDM理念,可降低住院患者跌倒的发生率,提高患者的安全和护理服务质量。

ObjectiveTo explore the application of shared decision making(SDM)concept,to enable osteoporosis patients and their families to participate in the assessment of fall risk and preventive measures,aiming to reduce the incidence of falls in hospitalized patients.MethodssAccording to the inclusion criteria and exclusion criteria,597 osteoporosis patients admitted from January 2017 to December 2017 were set as the control group,and 603 osteoporosis patients admitted from January 2018 to December 2018 were set as the intervention group.The control group adopted the traditional fall risk assessment and prevention measures,while the intervention group adopted the SDM concept to teach the high-risk patients and their families to use the Morse risk assessment form correctly,so that patients can better understand their fall risk level,continuously strengthen their belief in preventing falls,enhance the awareness of fall prevention,and worked out the fall prevention measures together with the patients and their families.The incidence of in-hospital fall was compared between the two groups.ResultsThrough the risk assessment of patients and their families and the development and implementation of fall prevention measures,the incidence of in-hospitalfall in the intervention group was lower than that of the control group(P<0.05),and the number of cases of moderate to severe injuries was reduced from 3 cases in the control group to 1 case in the intrvention group.ConclusionsThe application of the SDM concept can reduce the incidence of in-hospital fall and improve patient safety and quality of care.