患者参与结合互联网+在老年住院患者跌倒预防管理策略中的应用探讨

Application of fall prevention and management strategies based on patient participation and Internet plus in elderly inpatients

目的探讨患者参与结合互联网+在老年住院患者跌倒预防管理策略中的应用效果,并分析跌倒原因,为跌倒预防的持续改进提供依据。方法采用非同期前后对照研究,便利抽样法选取郴州市第一人民医院内科2020年6月1日至2021年5月31日住院的8480例老年患者为对照组,2021年6月1日至2022年5月31日住院的8662例老年患者为试验组。对照组采用常规跌倒预防措施,试验组在此基础上,根据患者参与框架"告知、参与、赋权、合作、电子化信息支持"5个阶段的内容制订并实施相应干预方案,并引入互联网+,比较2组患者的跌倒发生率、患者护理满意率。结果最终试验组纳入8662例[男5110例,女3552例,年龄(73.96±8.78)岁],对照组纳入8480例[男4918例,女3562例,年龄(74.11±8.59)岁]。试验组患者跌倒事件发生率为0.092%(8/8662),低于对照组的0.224%(19/8480),差异有统计学意义(χ^(2)=4.71,P<0.05),试验组患者护理满意率为98.880%(8565/8662),高于对照组的96.450%(8179/8480),差异有统计学意义(χ^(2)=106.50,P<0.01);对患者跌倒进行根本原因分析显示,卫生间蹲便器是应用干预方案后老年患者跌倒的重要隐患。结论患者参与结合互联网+的跌倒预防干预方案可以降低老年患者的跌倒发生率,提高患者护理满意率;患者跌倒的根本原因将不断变化,护理管理者应及时追踪,调整改进措施,并对基础设施在老年患者安全中的重要性予以重视。

Objective To explore the effectiveness of patient participation and Internet plus in fall prevention management strategies of elderly inpatients and analyze the causes of falls,so as to provide a basis for continuous improvement in fall prevention to investigate their continuous improvement.Methods A pre-and post-control study was conducted.Totally 8480 elderly inpatients hospitalized in the Department of Internal Medicine from 1 June 2020 to 31 May 2021 in Chenzhou NO.1 People's Hospital were selected by convenient sampling as the control group,and 8662 elderly inpatients hospitalized in the Department of Internal Medicine from 1 June 2021 to 31 May 2022 were in the experimental group.The routine fall prevention measures were used in the control group,and on this basis,the experimental group formulated and implemented fall prevention management strategies involving patients based on the patient participation framework"informing,participating,empowering,cooperating,and electronic information support"and introduced Internet plus.Then the differences between the two groups in terms of the incidence of falls and the satisfaction rate of nursing care were compared.Results The experimental group included 8662 cases(5110 males and 3552 females)with(73.96±8.78)years old,while the control group included 8480 cases(4918 males and 3562 females)with(74.11±8.59)years old.The incidence of falls in experimental group(0.092%,8/8662)was lower than that in control group(0.224%,19/8480),and the difference was statistically significant(χ^(2)=4.71,P<0.05);the nursing care satisfaction rate of experimental group(98.880%,8565/8662)was higher than that of control group(96.450%,8179/8480),and the difference also was statistically significant(χ^(2)=106.50,P<0.01);the analysis of the fall causes of the patients revealed that the toilet squatting commode was an important hidden risk of falls in elderly patients.Conclusions Fall prevention management strategies based on patient participation can reduce the incidence of falls in elderly patients and improve the satisfaction rate of nursing care.Patient participation introduced"Internet plus"can prevent patient falls.The root causes of patient falls will continue to change,and care managers should continually track real-time changes in the root causes of falls to identify problems,develop and adjust prevention strategies accordingly,and pay attention to the importance of infrastructure in the safety of older patients.