精神科病人跌倒预防措施的证据总结

Evidence summary of fall prevention measures for psychiatric patients

目的:检索并获取预防精神科病人跌倒的相关证据,为临床提供借鉴。方法:系统检索苏格兰校际指南网(SIGN)、美国指南网、UpToDate、澳大利亚Joanna Briggs Institute(JBI)循证卫生保健中心、EMbase、英国国家卫生与临床优化研究所(NICE)、the Cochrane Library、PubMed、中国知网(CNKI)、中国生物医学文献数据库(CBM)及精神科学术网站等关于预防精神科病人跌倒的证据,包括相关指南、最佳临床实践手册、证据总结、专家共识、系统评价或Meta分析及原始研究等。由2名研究人员对符合纳入标准的文献进行分析并提取相关证据同时对纳入研究进行质量评价。结果:共纳入文献14篇,包括系统评价1篇、指南1篇、随机对照试验1篇、横断面研究6篇、病例对照研究5篇,总结出了18条最佳证据,包括高风险因素识别、病区环境改善、重点病人管理、重点环节管理、饮食管理、运动锻炼、教育培训7个部分。结论:本研究总结了预防精神科病人跌倒的最佳证据,精神科临床护理工作者应定期开展跌倒相关知识的培训,将符合临床的最佳证据与病人的意愿及相应的医疗条件相结合,从而制定出针对性的干预策略,以降低精神科病人跌倒的发生率。

Objective:To search and obtain the relevant evidence on the prevention of falls in psychiatric patients,and to provide reference for clinical practice.Method:All evidence regarding the prevention of falls in psychiatric patients,including relevant guidelines,best clinical practice manuals,summary of evidence,expert consensus,systematic evaluation or Meta-analysis,and original research was retrieved from SIGN,NGC,UpToDate,JBI Evidence Based Health Care Center in Australia,EMbase,NICE,the Cochrane Library,PubMed,CNKI,CBM,and psychiatric academic websites.Two researchers analyzed the literature that met the inclusion criteria and extracted relevant evidence,while evaluating the quality of the included study.Result:A total of 14 articles were included,including 1 systematic review,1 guideline,1 randomized controlled trial,6 cross-sectional studies,and 5 case control studies.18 pieces of best evidence were summarized,including 7 parts:identification of high-risk factors,improvement of ward environment,key patient management,key environmental management,dietary management,exercise,and education and training.Conclusion:This study summarizes the best evidence for preventing falls in psychiatric patients.Psychiatric clinical nursing workers should regularly conduct training on fall related knowledge,combine the best evidence that meets clinical needs with the patient′s wishes and corresponding medical conditions,and develop targeted intervention strategies to reduce the incidence of falls in psychiatric patients.