81所三级甲等综合性医院老年住院患者跌倒预防证据应用现状调查

Investigation on the application status of falls prevention practice evidence in elderly inpatients in 81 Chinese comprehensive tertiary hospitals

目的了解老年住院患者跌倒预防证据在我国公立三级甲等综合性医院的应用现状。方法基于老年住院患者跌倒预防证据自行设计问卷,调查我国81所公立三级甲等综合性医院的证据应用现况。结果调查的81所医院中,93.83%(76/81)的医院将跌倒筛查纳入老年住院患者入院评估中,49.38%(40/81)的医院使用Morse跌倒评估量表进行跌倒筛查。同时,有老年住院患者跌倒评估的医院占62.96%(51/81),而将害怕跌倒、尿失禁、鞋袜穿着、足部问题等纳入老年住院患者跌倒筛查/评估的医院仅占25.93%~40.74%。此外,跌倒预防干预措施在调查医院中的实施率为12.35%~79.01%,且有实施个性化跌倒预防干预证据的医院仅占60.49%(49/81)。另一方面,护士、护工、患者、管床医生的跌倒预防参与率均高于80.00%,而药师、康复治疗师、物理治疗师的跌倒预防参与率仅为12.35%~24.69%。结论医院应根据院内环境及老年住院患者特征,确立应纳入跌倒筛查/评估的危险因素并选择适合的筛查/评估工具;鼓励、培养本院所需要的人员参与其中,并建立适合的多学科跌倒预防团队,推动跌倒评估及个性化跌倒干预措施在临床中的实施,从而达到应用老年住院患者跌倒预防证据,降低跌倒发生率及伤害率的效果。

Objective To investigate the application status of the practice evidence of falls prevention in elderly inpatients in Chinese comprehensive tertiary hospitals.Methods Using a self-designed questionnaire based on the practice evidence of falls prevention in elderly inpatients to investigate the application status of that in 81 Chinese comprehensive tertiary hospitals.Results 93.83%(76/81)of the investigated hospitals had a falls screen in the admission assessment of elderly inpatients,and 49.38%(40/81)of the surveyed hospitals used Morse Falls Scale to screen.At the same time,62.96%(51/81)of the hospitals had falls assessment of elderly inpatients,while only 25.93%-40.74%of the hospitals included the fear of falls,urinary incontinence,footwear,as well as foot problems in the falls screen or assessment.In addition,the implementation rate of falls prevention was 12.35%-79.01%in the hospitals surveyed,and only 60.49%(49/81)of the hospitals had individualized falls prevention intervention.Furthermore,the falls prevention participation rate of primary nurses and doctors,as well as patients′care was higher than 80.00%,but that of pharmacists,rehabilitation therapists and physiotherapists was only between 12.35%to 24.69%.Conclusions Hospitals should take the characteristics of environment and elderly inpatients in the hospital into consideration to choose the risk factors which should be included in the falls screen/assessment,as well as select the appropriate screen/assessment tools.Meanwhile,hospitals should culture and encourage the right workers′participation to build a multidisciplinary team for falls assessment and intervention to achieve the goal of falls and falls injuries prevention with the evidence.