老年住院患者跌倒事件的回顾性分析及护理管理对策研究

Retrospective analysis of falls in aged inpatients and research on nursing management strategies

目的描述老年住院患者跌倒事件的临床特征、发生原因,为医院完善跌倒预防的护理管理策略提供参考。方法回顾性收集北京医院2013年1月-2019年12月通过护理不良事件上报系统上报的121例次老年住院患者跌倒事件,分析事件的临床特征和发生原因。结果121例次老年住院患者跌倒事件中,白班累计45例次,夜班累计76例次;跌倒地点最常见的为床边60例次,占49.6%,其次为病房外的其他地点35例次,占28.9%;跌倒原因排序前3位占比近80%,分别为护士因素39例次,患者因素34例次,环境因素22例次;跌倒结局中,无损伤44例次,轻度损伤47例次,中度损伤6例次,重度损伤23例次,死亡1例。结论老年住院患者跌倒风险大、发生率高、损伤程度重、风险因素和原因复杂,对老年住院患者跌倒预防的护理管理要从多维度入手,重视健康教育效果的回馈和过程监管,调动老年住院患者参与安全管理的主动性,在老年患者功能锻炼和安全管理中找到新的平衡点,科学有效地保障患者安全。

Objective To describe the clinical characteristics and causes of falls in aged inpatients,and provide a reference for the hospital to improve the nursing management strategies for fall prevention.Methods Totally 121 falls in aged inpatients reported via the nursing adverse events reporting system in Beijing Hospital from January 2013 to December 2019 were retrospectively collected,and the clinical characteristics and causes of these events were analyzed.Results Among the 121 falls in aged inpatients,there were 45 in day shift and 76 in night shift.The most common place of fall was 60 at the bedside,accounting for 49.6%,followed by 35 outside the ward,accounting for 28.9%.The top 3 causes of falls accounted for nearly 80%,including 39 caused by nurses,34 caused by the patients,and 22 caused by the environment.As for the outcome of falls,there were 44 without injury,47 with mild injury,6 with moderate injury,23 with severe injury,and 1 dead case.Conclusions Aged inpatients are at high risk of falls,which are characterized by high incidence,severe injuries,and complex risk factors and causes.The nursing management of fall prevention for aged inpatients should start from multiple aspects,pay attention to the feedback of health education effects and process supervision,mobilize aged inpatients to participate safety management,find a new balance between functional exercise and safety management of aged patients,and ensure patient safety properly and effectively.