心内科住院患者意外跌倒的原因分析及对策

目的探讨心内科住院患者意外跌倒发生的原因及对策。方法对心内科2005年1月～2010年12月住院的15400例患者进行回顾性分析,了解患者跌倒的情况及跌倒发生的原因。结果 31例患者发生跌倒,占住院患者0.20%,年龄因素15例,占跌倒患者48.39%;自身疾病因素6例,占19.35%;药物因素5例,占16.13%;患者自我认知缺乏因素3例,占9.68%;护士责任心不强因素2例,占6.45%。结论心内科住院患者跌倒与患者年龄、自身疾病、服用药物、自我认知缺乏及护士责任心不强等因素相关,应提高护士对患者跌倒的预测能力,提供全面周到的护理服务,从而降低心内科住院患者跌倒的发生率。     

帕金森病患者跌倒风险影响因素及管理应对

目的探讨帕金森病患者跌倒风险情况及影响因素,拟定管理应对措施,以期降低这类人群跌倒发生率。方法选取2016年5-11月入住神经科内科、老年医学科符合诊断标准的103例帕金森病住院患者作为调查对象,由2名经过专用量表培训的研究护士负责全部问卷调查,包含(1)患者一般情况调查表及其他;(2)改良跌倒风险评估表11个方面;(3)BI表评估患者日常生活活动能力。结果103例帕金森病住院患者均存在不同等级跌倒风险,其中低危占20%、高危占44%、极高危占36%。自理能力等级轻度依赖占49.5%、中度依赖16.5%、重度依赖10.7。跌倒风险Spearman相关分析结果:患者年龄、病情分期、自理程度、运动症状、自主神经异常、情感异常与跌倒风险呈显著正相关(P0.05);静止性震颤、BI、Braden评分与跌倒风险呈显著负相关(P0.05)。跌倒风险多因素逐步多元回归分析显示:日常活动能力、自主神经异常、震颤是帕金森病患者住院期间跌倒危险因素(P0.05)。结论帕金森病患者住院期间均存在跌倒风险,日常活动能力缺陷、自主神经异常、震颤是帕金森病患者住院期间跌倒高危因素。帕金森病患者住院期间应进行跌倒风险评估,并根据评估结果,尤其应关注高危影响因素,积极采取预防跌倒各项管理应对措施,以降低跌倒不良事件发生,提升这类人群的生活质量。     

对21例住院患者跌倒的调查分析及对策

目的分析住院患者发生跌倒的相关因素,以探讨有效的干预措施。方法回顾性调查我院2005～2006年上报的21名住院患者发生跌倒的资料。结果两年内住院患者跌倒发生率为0.02%,年龄为(68.52±18.19)岁;病情方面,癌症占33.34%,脑梗死、冠心病、高血压占28.57%,术后占14.29%,肺部感染占9.52%;时间方面,发生在傍晚及夜间占80.95%;入院1周内发生跌倒占47.62%;跌倒因素方面,跌倒与体位改变相关占71.43%;跌倒前有服药史占71.43%;跌倒时有家属或护工陪伴占52.38%;预后方面,跌倒造成不同程度后果者占76.19%。结论应加强住院患者跌倒高危因素的评估,对住院环境进行审核和纠正,加强护患双方防范跌倒的宣教,最大程度地降低住院患者跌倒的发生率。     

139例住院患者跌倒不良事件分析

目的回顾性分析住院患者跌倒不良事件的临床特点,为制定有效的跌倒预防策略提供参考依据。方法通过医院护理管理平台收集2015年1月—2018年12月发生的139例跌倒护理不良事件的临床资料,统计分析相关数据。结果跌倒患者以老年人为主,占64.03%(89/139);发生跌倒次数最多的地点是卫生间,占54.67%(76/139);跌倒高发时间段为清晨(6:00~8:00)和午夜(0:00^-2:00);患者跌倒发生时当班护士以低年资护士为主;患有肿瘤相关疾病、心脑血管疾病及内分泌、代谢疾病的患者跌倒发生率高于其他基础病患者。跌倒评估不够准确/未能识别高危人群、高危患者无防控措施、患者依从性差、护士健康宣教不到位以及环境因素是导致住院患者跌倒的常见根本原因。结论护理管理者及临床护理人员,应关注跌倒不良事件的高危人群、高发地点及时间段等,实施预见性护理,从而预防跌倒的发生。     

住院患者跌倒原因分析与防范对策

目的 分析住院患者发生跌倒的因素,以探讨有效的预防措施。方法 回顾我院2009年1月-2013年12月住院患者发生意外跌倒事件144例,对发生跌倒的时间段、地点、疾病和用药因素进行统计分析。结果 20：00-7：00是跌倒发生的主要时间段;在卫生间、病床边是跌倒发生的主要影响因素;肿瘤化疗后的患者、服用缓泻剂、降压药的患者易发生跌倒。结论 加强住院患者跌倒高危因素评估,实施有效的防范措施,能减少患者跌倒的发生率。     

住院患者跌倒16例原因分析

目的：探讨住院患者跌倒的原因，防止患者意外跌倒。方法：对10例住院发生跌倒患者，采取填写患者跌倒登记表，由护理部人员通过调查、访谈的形式；对患者跌倒的意外因素进行评估、分析。结果：造成患者跌倒的因素与高龄活动无耐力，室内外环境因素，护士人力资源相对不足、陪护人员责任心等有关。结论：针对各因素明确高危患者，做好患者的入院危险因素评估，采取有效防范措施及健康教育，降低住院患者跌倒的发生。     

住院精神病患者跌倒原因分析与护理防范

目的探讨住院精神病患者发生跌倒的原因及护理防范措施。方法采用自行设计的调查问卷,收集2011年1月~2012年12月我院住院精神病患者938例的资料,对发生跌倒54例患者的跌倒原因及相关情况进行分析。结果住院精神病患者跌倒发生率为5.76%,高于普通人群的跌倒发生率。跌倒的原因与病情因素、机体因素、药物因素、封闭式环境因素有关。结论针对住院精神病患者发生跌倒的原因,提出有针对性的护理防范措施,降低住院精神病患者跌倒的发生率,减轻患者的痛苦,保证住院期间的安全。     

住院老年患者跌倒因素分析及防范措施

目的:探讨住院老年患者跌倒因素,并开展针对性较强的防范措施。方法:选取本院住院老年患者702例进行跌倒高危因素评价及分析,并针对相关高危因素进行原因分析,提出针对性较强的护理措施。结果:在跌倒危险因素中,疾病因素572例(81.5%),日常生活能力丧失512例(73.0%),常规用药影响499例(71.1%),生理因素428例(61.0%),既往有跌倒病史者211例(30.1%)。结论:临床工作中针对相关因素,改善不良环境,积极治疗基础疾病,加强安眠、麻醉等药物的管理,开展疾病相关知识及安全知识培训,以上措施能明显降低老年患者跌倒的发生率,改善住院老年患者生活质量。     

血液病跌倒高危患者的影响因素分析及预测模型的研究

目的研究影响血液病患者跌倒的主要因素,为血液病跌倒高危患者的筛查工作提出建议。方法采用问卷调查和访问数据库的方法对2019年5月-2020年1月在我院住院的120例血液病患者及其陪护人员基本信息进行调查。在排除部分血液病患者跌倒影响因素后(P≥0.05),使用剩余因素建立血液病跌倒高危患者的预测模型。研究对象按是否发生跌倒或跌倒动作分为跌倒高危患者18例(16%)和非跌倒高危患者94例(84%),分别用于训练和验证模型。结果患者的认知程度(β=-0.8038,OR=0.448,95%CI:0.240～0.835)是跌倒风险的主要影响因素;验证集34例患者中有8例被确认为跌倒高危对象;模型准确率、灵敏度、特异性和AUC分别为97.2%、100%、97.30%和1。结论采用血液病跌倒高危患者的预测模型筛选跌倒高危对象区分度较好,适用于血液病跌倒高危患者的筛查工作。     

跌倒危险因素评估报告及预防记录表在血液病患者中的应用

目的防范与减少血液科住院患者跌倒事件,降低跌倒的发生率。方法参考相关文献,结合血液科患者情况,设计《血液科住院患者跌倒危险因素评估报告及预防记录表》,对1 325例住院患者进行跌倒危险因素评分,≥3分者应用跌倒危险因素评估报告及预防记录表进行护理干预,与未使用前1 252例患者跌倒的发生率进行比较。结果应用跌倒危险因素评估报告及预防记录表后,血液科住院患者跌倒发生率明显下降(P<0.01)。结论对高危跌倒患者进行评估报告,有效做好三级监控,针对性采取防范措施,能有效避免患者跌倒的发生。     

北京某三级甲等医院住院患者跌倒事件及影响因素调查

目的：分析住院患者跌倒的发生特点及相关因素,为采取针对性护理措施以降低跌倒的发生提供参考和依据。方法对2009-2012年上报的57例住院患者的跌倒事件及相关因素进行回顾性分析。结果跌倒患者平均（65．61±16．92）岁,64．9％的跌倒发生于夜班、中午或交接班时间段,71．4％的跌倒发生于节假日,77．2％的跌倒患者为二级护理,52．7％的跌倒患者有陪护,在跌倒发生时,62．1％的陪护不在场。结论多种因素如患者高龄、护士人力不足、巡视不够、陪护不力等都可引起跌倒的发生。提高护士人力配置,控制跌倒的危险因素,加强跌倒防范教育是减少住院患者跌倒的根本措施。     

Validation of the Hendrich II Fall Risk Model: The imperative to reduce modifiable risk factors

AimTo validate the psychometrics of the Hendrich II Fall Risk Model (HIIFRM) and identify the prevalence of intrinsic fall risk factors in a diverse, multisite population.BackgroundInjurious inpatient falls are common events, and hospitals have implemented programs to achieve “zero” inpatient falls.MethodsRetrospective analysis of patient data from electronic health records at nine hospitals that are part of Ascension. Participants were adult inpatients (N = 214,358) consecutively admitted to the study hospitals from January 2016 through December 2018. Fall risk was assessed using the HIIFRM on admission and one time or more per nursing shift.ResultsOverall fall rate was 0.29%. At the standard threshold of HIIFRM score ≥ 5, 492 falls and 76,800 non-falls were identified (fall rate 0.36%; HIIFRM specificity 64.07%, sensitivity 78.72%). Area under the receiver operating characteristic curve was 0.765 (standard error 0.008; 95% confidence interval 0.748, 0.781; p < 0.001), indicating moderate accuracy of the HIIFRM to predict falls. At a lower cut-off score of ≥4, an additional 74 falls could have been identified, with an improvement in sensitivity (90.56%) and reduction in specificity (44.43%).ConclusionAnalysis of this very large inpatient sample confirmed the strong psychometric characteristics of the HIIFRM. The study also identified a large number of inpatients with multiple fall risk factors (n = 77,292), which are typically not actively managed during hospitalization, leaving patients at risk in the hospital and after discharge. This finding represents an opportunity to reduce injurious falls through the active management of modifiable risk factors.     

住院患者跌倒不良事件的临床特征研究

目的 调查分析住院患者跌倒不良事件的临床特征,为预防院内跌倒不良事件的发生提供依据.方法 对2017年1月至2018年12月汕头大学医学院第二附属医院及汕头市中心医院上报的110例跌倒不良事件进行回顾性研究分析.结果 住院患者跌倒以老年人为主(70.91％),多数发生在夜间,发生跌倒呈现三个高峰时间段,分别为3:00-...     

住院老年精神障碍患者跌倒的调查与护理

目的调查住院老年精神障碍患者跌倒的发生情况及其危险因素。方法利用自制跌倒发生情况调查表、跌倒危险因素调查表，对756例住院的老年精神障碍患者进行回顾性调查。结杲（1）老年精神障碍患者在院期间跌倒发生率为18．0％。（2）单因素分析表明，痴呆、合并躯体疾病、首次精神药物使用等9个变量与跌倒有关。（3）多因素分析表明，跌倒的主要危险因素有痴呆、服用抗精神病药物、伴发糖尿病、合并使用降压药等。结论住院老年精神障碍患者跌倒发生率高，护理中应予以重视，并针对性采取防范措施。     

Falls sustained during inpatient rehabilitation after lower limb amputation: prevalence and predictors

OBJECTIVE: The purpose of this study is to identify risk factors for falling and fall-related injury among a group of inpatients undergoing rehabilitation after major lower limb amputation. DESIGN: Retrospective cohort. RESULTS: Out of 1267 patients, 260 (20.5%) fell at least once. There were a total of 374 falls, 67 (17.9%) of which resulted in one or more injuries. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated for factors significantly associated with falling, including age of > or =71 yrs (OR = 1.40, 95% CI = 1.02-1.89), lengths of stay of 22-35 days (OR = 2.97, 95% CI = 1.14-7.72) or >5 wks (OR = 6.07, 95% CI = 2.34-15.71), four or more comorbidities (OR = 1.93, 95% CI = 1.09-3.41), cognitive impairment (OR = 1.68, 95% CI = 1.02-2.78), two or more as-needed medications (OR = 1.81, 95% CI = 1.02-3.21), benzodiazepines (OR = 2.22, 95% CI = 1.24-3.96), and opiates (OR = 5.76, 95% CI = 3.29-10.09). Factors significantly associated with fall-related injuries included bilateral amputation (OR = 3.68, 95% CI = 1.49-9.05) and falls during the day shift (OR = 2.63, 95% CI = 1.24-5.57). CONCLUSIONS: One in five patients with lower limb amputation will likely experience at least one fall during inpatient rehabilitation, with 18% sustaining an injury. Ongoing research is required to develop appropriate intervention strategies to ameliorate the risk of falling during inpatient rehabilitation.     

Retrospective analysis of falls in an inpatient rehabilitation centre for rheumatic and orthopaedic diseases

AIM: To analyse the frequency and circumstances of falls in an inpatient rehabilitation centre. METHODS: In a survey all falls reported to the Austrian accident insurance carrier were analysed and external circumstances of falls were evaluated. The survey covers a period of 64 months (Jan 2000 to April 2005): 10 820 inpatients (234 502 patient days); mean age 52.8 years; 1,252 patients aged >/= 70 years; 47 % male, 53 % female. RESULTS: Of 223 accidents registered, 140 (62.8 %) were falls. Of these, 17 patients had to be referred to a surgical unit for further treatment. In total, 1.29 % of all patients fell during their stay (with report to the accident insurance carrier), 0.16 % suffered major injuries from falls (with referral to surgical unit). Females fell more frequently than males. 39 % of the falls were associated with physical therapy. Most falls occurred in daytime. The location in the centre or the day of week showed no major influence on the frequency of falls. Falls occurred slightly more often in the first part of the three-week inpatient stay. CONCLUSION: The high total number of falls shows that falls are important in an inpatient rehabilitation centre for rheumatic and orthopaedic diseases. The analysis did not reveal any special location inside the rehabilitation centre with an increased risk of falls calling for urgent interventions. The active and activating physical therapies do not seem to increase the number of falls significantly.     

Number of nursing staff and falls: a case-control study on falls by stroke patients in acute-care settings

Falls occur frequently in patients with a stroke and have serious consequences discharge delays and hip fractures can result In order to evaluate the impact of nursing workload on stroke-patient falls, we assessed the patients per nurse ratio in a detailed case-control study earned out in nine Dutch hospitals There were 49 first falls by 349 stroke patients Between the cases and controls there was no difference in the means of these ratios for any type of nurse and any type of patient on the day and evening shift We found that the greatest number of falls ( n = 26) occurred on the day shift when most nursing staff were present On the night shift, we found a significant difference between the means of the patient per nurse ratios (95% confidence interval 0 28–2 20), but the number of cases was very small Of the falls, 35% occurred within the first week of admission We found 19 cases in a subgroup of 138 patients that could be checked with the hospital incidents report committees This review yielded three additional cases, but nine cases were not reported to these committees We conclude that simply increasing number of nurses is not likely to diminish the number of falls     

A study on the relationship between age and inpatient falls in Taiwan

Falls are the most frequently reported adverse hospital events. How to prevent inpatients from falling has become an important issue of patient safety in hospitals. The purpose of this study was to investigate the correlation between age and inpatient falls. A retrospective study design was used. This study, which extracted information from fall‐related incident reports, enrolled patients who had fallen during hospitalization in Taiwan. Of the 221 falls evaluated, 63.8% had occurred under companion care, 98.2% of patients had fallen once and most fall‐related injuries were minor (46.6%). Falls occurred most frequently when patients were going to the toilet, walking and being moved. There were significant correlations with age groups and fall‐related factors (P = 0.000; P < 0.05), the presence/absence of a companion (P = 0.022, P < 0.05), the situation of falls (P = 0.000; P < 0.05), and fall‐related injuries (P = 0.000, P < 0.05). Preventive interventions related to falls should vary for different age groups.