离床报警器预防老年痴呆患者夜间走失的临床应用

目的探讨离床报警器用于预防老年痴呆患者夜间走失的效果。方法将73例患者按住院时间分为对照组33例、观察组40例,对照组实施防走失常规护理,观察组在对照组基础上,住院期间每天夜间增加使用离床报警器预防走失。比较两组患者夜间走失发生情况以及家属对预防走失措施的满意度。结果对照组患者走失发生率为18.18%,观察组为0;观察组患者家属对预防走失措施满意度为97.5%,对照组为78.8%,组间比较差异均有统计学意义。结论离床报警器可有效降低老年痴呆患者夜间走失的发生率。     

住院患者跌倒与坠床的高危因素及预防

马斯洛的人类基本需要层次理论中,安全需要是第二层次的需要。每个人都有安全的需要,对患者而言尤为重要。跌倒和坠床是医院中较为常见的不安全因素。跌倒是指身体任何部位因失去平衡而意外触及地面或其他低于平面的物体。防范住院患者跌倒与坠床是评价医院医疗护理质量的一个重要指标。预防住院患者跌倒和坠床是护理人员应该关注的问题,本文对住院患者跌倒与坠床的高危因素及预防作综述。     

“预防患者跌倒/坠床告知书”在脑卒中患者中的应用体会

跌倒是住院患者常发生的不良事件,可导致5%～15%患者脑部损伤、软组织挫伤、骨折、脱臼甚至死亡,不仅给患者心身带来痛苦,而且会造成医疗护理纠纷和医疗费用的增加。脑卒中住院患者由于疾病因素、心理因素、药物因素、环境因素以及陪护因素等各方面的原因,容易发生跌倒、坠床等不良事件。为了减少脑卒中患者跌倒     

跌倒坠床风险评估单在老年住院患者中的应用

总结了老年住院患者发生跌倒坠床的各种因素及预防措施,包括跌倒坠床评估风险,采取相应防范措施,加强患者及家属的宣教,强化护士防跌倒坠床意识等.认为跌倒坠床风险评估对于预防老年住院患者跌倒坠床起到了很大的作用,可有效降低老年住院患者的跌倒坠床率,保证了患者的住院安全,提高了护理质量.     

综合干预措施在预防跌倒/坠床事件发生中的应用

目的探讨综合干预措施在康复医学科住院患者预防跌倒/坠床中的应用效果。方法对住院患者跌倒/坠床危险因素进行评估,落实防范住院患者跌倒/坠床风险的安全综合干预措施,并比较实施综合干预前后住院患者的跌倒/坠床发生情况。结果实施综合干预后,住院患者跌倒/坠床发生率明显降低。结论通过综合干预在康复医学科的应用,有效地防止了跌倒/坠床事件的发生,降低了病患的痛苦,减少了不必要的医患纠纷。     

住院儿童跌倒/坠床预防的证据总结

目的 检索国内外关于住院儿童跌倒/坠床预防的最佳证据,并进行总结.方法 通过计算机检索美国指南网、英国卫生与临床优化研究所、苏格兰校际指南网络、加拿大临床实践指南数据库、澳大利亚JBI循证卫生保健中心、加拿大安大略注册护士协会、医脉通、PubMed、OVID、Embase、Web of science、中国知网和万方数...     

共同参与护理模式在预防高危患者跌倒中的应用

目的：探讨运用共同参与护理模式对预防跌倒高危患者跌倒的作用。方法选择2012年1月～2013年12月在我院住院治疗的肝胆病跌倒高危患者为研究对象,其中2012年1月～12月为对照组,2013年1月～12月为实验组;对照组采用常规护理,实验组在常规护理基础上将患者、家属纳入到预防跌倒支持体系中,护士对患者及家属进行有效指导,取得患者及家属的参与和配合,共同参与到预防跌倒的护理中,比较2组患者跌倒发生率。结果运用共同参与护理模式后,患者跌倒率及跌倒后损伤率均有所下降,差异有统计学意义（P＜0．05）。结论共同参与模式有利于降低高危患者跌倒不良事件的发生。     

风险管理在住院患者跌倒／坠床预防中的应用

目的：探讨风险管理预防患者跌倒／坠床事件发生的实践及效果。方法：2010年1-12月住院患者采用常规预防跌倒／坠床管理方法,2011年1-12月住院患者采用预防跌倒／坠床风险管理。比较预防跌倒／坠床风险管理实施前、后患者跌倒／坠床发生率。结果：预防跌倒／坠床风险管理前患者跌倒／坠床的发生率为0．88‰,实施后为0．45‰。结论：实施风险管理,可明显降低住院患者跌倒／坠床的发生率,提高护理质量,保障患者安全。     

两种健康教育方式在预防精神科住院患者跌倒中的应用

目的探讨两种不同的健康教育方式对预防精神科住院患者跌倒的效果。方法将两个病区住院患者160例随机分为对照组和观察组,各80例。对照组采用集体健康教育方式,观察组采用有针对性的个体化健康教育方式。结果观察组对预防跌倒相关知识了解程度明显高于对照组;住院期间观察组跌倒发生率明显低于对照组。结论对精神科住院患者实施有针对性的预防跌倒个体化健康教育,能提高精神科患者对跌倒危险因素的认知,有效降低跌倒发生率。     

Tetrax跌倒指数测定对社区老年人跌倒预防的效果

目的探讨老年人跌倒的发生与Tetrax跌倒指数的关系,评估按照该指数进行健康宣教的效果,为老年人跌倒预防提供科学依据。方法便利抽样选择上海市宝山区某社区的60岁以上老年人300名,随机分为观察组和对照组各150例。观察组给予Tetrax跌倒指数测定,并且通过机器数据语言获取老年人跌倒的风险指数及来源,同时进行有针对性的预防跌倒宣教及康复治疗;对照组通过社区活动实施预防跌倒宣教。统计1年后两组老年人跌倒发生情况,并分析Tetrax跌倒指数高低与跌倒发生率、疾病之间的关系。结果观察组老年人跌跤发生率明显低于对照组(P0.05);不同Tetrax跌倒风险级别及患不同慢性疾病的老年人跌倒发生率存在差异(P0.05)。结论 Tetrax跌倒指数测定并参照该指数进行重点宣教,有助于降低老年人跌倒风险,为老年人跌倒的预防提供科学依据。     

Biomechanical Evaluation of Injury Severity Associated with Patient Falls from Bed

This study investigated the severity of injuries associated with falling from bed and the effectiveness of injury‐prevention strategies. Injury criteria were calculated for head‐ and feet‐first falls from six bed heights onto a tiled surface and floor mat. These values indicated a 25% chance of experiencing a serious head injury as a result of falling feet‐first from a bed height of 97.5 cm onto a tiled surface. Risk of injury increased to 40% when extrapolated for the height added by bedrails. Using a floor mat decreased this risk to less than 1% for bedrail height for feet‐first falls. Calculated impact forces indicated a risk of skull fracture when hitting the tiled surface. Floor mats and height‐adjustable beds positioned to the lowest height should be used to decrease the risk of injury associated with falling from bed.     

Identification of Fall Risk Factors in Older Adult Emergency Department Patients

Objectives: Falls represent an increasingly frequent source of injury among older adults. Identification of fall risk factors in geriatric patients may permit the effective utilization of scarce preventative resources. The objective of this study was to identify independent risk factors associated with an increased 6‐month fall risk in community‐dwelling older adults discharged from the emergency department (ED). Methods: This was a prospective observational study with a convenience sampling of noninstitutionalized elders presenting to an urban teaching hospital ED who did not require hospital admission. Interviews were conducted to determine the presence of fall risk factors previously described in non‐ED populations. Subjects were followed monthly for 6 months through postcard or telephone contact to identify subsequent falls. Univariate and Cox regression analysis were used to determine the association of risk factors with 6‐month fall incidence. Results: A total of 263 patients completed the survey, and 161 (61%) completed the entire 6 months of follow‐up. Among the 263 enrolled, 39% reported a fall in the preceding year, including 15% with more than one fall and 22% with injurious falls. Among those completing the 6 months of follow‐up, 14% reported at least one fall. Cox regression analysis identified four factors associated with falls during the 6‐month follow‐up: nonhealing foot sores (hazard ratio [HR] = 3.71, 95% confidence interval [CI] = 1.73 to 7.95), a prior fall history (HR = 2.62, 95% CI = 1.32 to 5.18), inability to cut one’s own toenails (HR = 2.04, 95% CI = 1.04 to 4.01), and self‐reported depression (HR = 1.72, 95% CI = 0.83 to 3.55). Conclusions: Falls, recurrent falls, and injurious falls in community‐dwelling elder ED patients being evaluated for non–fall‐related complaints occur at least as frequently as in previously described outpatient cohorts. Nonhealing foot sores, self‐reported depression, not clipping one’s own toenails, and previous falls are all associated with falls after ED discharge.     

脑卒中跌倒预防策略性靶向训练技术的研究

目的探索认知注意力训练、空间位置觉本体感觉训练和下肢协调性训练对脑卒中患者下肢肌群平衡协调功能的影响。方法100 例脑卒中患者随机分为对照组和观察组各50 例。对照组进行常规康复治疗,观察组在此基础上增加认知注意力训练、空间位置觉训练及下肢协调性训练。康复训练前及训练1 个月后,通过静态平衡测试仪和Berg 平衡功能测试量表进行评定。结果对照组和观察组平衡功能均有改善(P<0.05);与对照组比较,观察组治疗后轨迹长度、轨迹总面积、单位面积轨迹长显著下降(P<0.001),而Berg 评分显著上升(P<0.001)。结论空间位置觉训练、认知注意力训练和下肢协调性训练可增加脑卒中患者平衡能力。     

Fall incidence and fall prevention practices at acute care hospitals in Singapore: a retrospective audit

OBJECTIVE: To investigate the incidence of falls and explore fall prevention practices at acute care hospitals in Singapore. DESIGN: A retrospective audit to collect baseline data on (1) incidence of falls (patient fall rates and fall injury rates) and (2) fall prevention practices, was conducted in five acute care hospitals in Singapore from December 2004 to March 2005. STUDY PARTICIPANTS: Medical record data (n = 6000) of patients admitted into the medical, surgical and geriatric units in the five hospitals. OUTCOME MEASURES: Fall incidence was obtained from the hospital's fall databases and incident reports for the period of June 2003 to May 2004. In total, 6000 medical records from five hospitals were randomly selected, retrieved and reviewed to determine whether falls, fall assessments and interventions were being initiated and documented. RESULTS: The number of fallers for all hospitals was 825. Analysis showed that patient fall rates ranged from 0.68 to 1.44 per 1000 patient days, and the proportion of falls associated with injury ranged from 27.4% to 71.7%. The use of a fall risk assessment tool by nurses was recorded in 77% of all the nursing records. CONCLUSION: This study has laid the foundation for further research for fall prevention in Singapore by describing current fall rates, fall-associated injury rates and the status of fall prevention practices in acute care settings. The results will be used to inform the development of a tailored multifaceted strategy to facilitate the implementation of Fall Prevention Clinical Practice Guidelines to reduce the burden of falls and fall injuries in hospitals in Singapore.     

老年患者预防跌倒知识与行为调查

目的了解老年患者预防跌倒知识的掌握情况及其行为,针对性地做好老年患者的健康教育,有效预防跌倒的发生。方法采用自行设计的问卷,调查108例住院老年患者预防跌倒的知识及行为。结果 68.5%老年患者不知道预防跌倒的方法,65.7%不知道跌倒后的应急处理方法,58.3%不知道跌倒与药物影响有关,52.8%不知道跌倒与疾病因素有关;59.3%认为跌倒不可以预防,仅有38.9%能主动向他人求助,32.4%能选择正确的活动方式,24.1%能选择使用助行器。结论老年患者预防跌倒的知识欠缺,预防跌倒的意识及行为不容乐观。应加强对老年患者预防跌倒知识的健康教育,提高老年患者预防跌倒的意识及行为,从而有效预防跌倒的发生。