目的性巡视预防脑卒中患者跌倒的应用研究

Application study of targeted patrol in prevention of falls in stroke patients

目的探讨目的性巡视在脑卒中患者防跌倒管理中的应用效果。方法选择2018年1月~2019年6月在南京市某三级医院神经内科住院的632例脑卒中患者,将2018年1月~2018年9月收治的322例脑卒中患者列为对照组,将2018年10月~2019年6月收治的310例脑卒中患者列为观察组。对照组按照常规干预及护理措施,观察组在常规干预措施上,实施跌倒专科管理:完善跌倒评估,加强患者和护士的预防跌倒宣教,结合目的性巡视,重点关注患者体位改变、上下床、入厕排泄、物品摆放位置等4个方面。比较观察组两种跌倒评估量表评估结果的阳性率差异、两组患者在入院和出院时的国际版跌倒效能量表(FES-I)差异及两组患者在院患者跌倒发生率情况。结果观察组中约翰霍普金斯跌倒评估量表评估的阳性率明显高于Morse跌倒评估量表评估结果(P<0.05);干预后观察组FES-I评分与对照组比较,明显升高(P<0.05);且干预后观察组跌倒发生率明显降低,差异均有统计学意义(P<0.05)。结论目的性巡视不仅可使患者预防跌倒的自信心增强,还可有效降低脑卒中患者跌倒的发生。

Objective To investigate the effect of targeted patrol in the fall prevention management of stroke patients.Methods A total of 632 stroke patients admitted to the Department of Neurology,a third-grade hospital in Nanjing from January 2018 to June 2019 were enrolled.The 322 stroke patients admitted from January 2018 to September 2018 were included in the control group.310 stroke patients admitted from October 2018 to June 2019 were included in the observation group.The control group was treated with routine intervention and nursing measures.The observation group implemented the fall specialized management based on the routine intervention measures including improving the fall assessment,strengthening the fall prevention education for patients and nurses,combined with the targeted patrol,focusing on the patient’s position change,going to and getting out of bed,toilet discharge and item placement.The difference between the positive rate of the two fall assessment scales in the observation group,the international version of the fall effect energy meter(FES-I)at the time of admission and discharge,and the incidence of falls in the two groups of patients were compared.Results The positive rate of the Johns Hopkins Fall Assessment Scale in the observation group was significantly higher than that of the Morse Fall Assessment Scale(P<0.05).After the intervention,the FES-I score of the observation group was significantly higher than that of the control group(P<0.05).And the incidence of falls was significantly lower in the observation group after intervention(P<0.05),and the difference was statistically significant.Conclusion Targeted patrol can not only enhance the patient’s self-confidence in preventing falls,but also effectively reduce the incidence of falls in stroke patients.