住院患者跌倒预防相关临床实践指南的质量评价及推荐意见总结

Quality evaluation of clinical practice guidelines related to fall prevention in inpatients and its recommendations summary

目的对国内外住院患者跌倒预防相关临床实践指南进行质量评价和推荐意见总结。方法系统检索国内外指南网、医学文献数据库以及专业学术网站,应用相应评价工具对纳入指南和专家共识进行质量评价,并汇总相关推荐内容。检索时限为建库至2022年12月13日。结果共纳入9篇指南和5篇专家共识,9篇指南在AGREE II 6个领域得分为范围和目的94.03%、清晰性73.86%、参与人员76.07%、严谨性80.19%、应用性69.34%、独立性63.88%,其中5篇为A级推荐、4篇为B级推荐;3篇专家共识中的质量评价结果中条目1~6均为“是”,其余2篇条目1~4均为“是”,条目5~6分别为“否”和“不清楚”,5篇专家共识质量评价结果均为“纳入”。经内容整理,住院患者跌倒预防相关内容包括环境改善、跌倒风险评估、跌倒干预及跌倒后处理、药物审查、物理训练、保护器具的使用、营养支持、健康宣教8个方面,28项内容。结论本研究纳入的住院患者跌倒预防指南整体质量较好但仍有待提高,对临床护理人员预防患者跌倒、提高护理质量有一定的指导意义。

Objective To evaluate the quality of domestic and foreign Clinical Practice Guidelines related to fall prevention and summarize recommendations.Methods The domestic and foreign guidelines websites,medical literature databases,and professional academic websites were searched systematically,and the quality of the included guidelines and expert consensus was evaluated by using the corresponding evaluation tools,and the related recommendations were summarized and analyzed.The retrieval period was from the inception of detabases to Dec13,2022.Results A total of 9 guidelines and 5 expert consensus articles were included,and the scores of the 9 guidelines in AGREE II 6 fields were 94.03%for scope and purpose,73.86%for clarity,76.07%for participants,80.19%for rigor,69.34%for application,and 63.88%for independence,5 of which were A Grade recommendation,4 for Grade B recommendation;In the quality evaluation results of the 3 expert consensus articles,items 1-6 were"yes",the other 2 articles 1-4 were"yes",items 5-6 were''no''and''unclear''respectively,and the quality evaluation results of the 5 expert consensus articles were''included''.Through content analysis,the contents related to fall prevention of inpatients included 28 items in 8 aspects,including environmental improvement,fall risk assessment,fall prevention and fall post-treatment,drug review,physical training,use of protective equipment,nutrition support,health education.Conclusions The overall quality of fall prevention guidelines for inpatients included in this study is good but still needs to be improved,and have certain guiding significance for clinical nurses to prevent patients from falling and improve the quality of nursing.