Strategies to reduce risk of fall-related injuries in rehabilitation nursing.

Rehabilitation nurses are in a critical position to lead interdisciplinary team fall prevention management, including injury risk reduction. This article provides an update for rehabilitation nurses on evidence-based strategies to reduce patients'risk of fall-related injuries. This content builds on existing literature by focusing on knowledge to promote patient responses that reduce the risk of falls and ultimately fall-related injuries. Although rehabilitation nurses understand the complex nature of falls, addressing the intrinsic and extrinsic risk factors that increase the risk of fall-related injuries requires both individually based treatment programs and a system-wide commitment. A plethora of literature discusses fall risks and falls, but this article profiles the at-risk patient and describes current and emerging evidence-based interventions to protect patients from fall-related injuries by reducing risk factors. This discussion is limited to exercise, environmental redesign, osteoporosis prevention, and hip protectors.     

北京市某社区老年人跌倒风险及其影响因素分析

目的:调查北京市某社区老年人跌倒风险现状,并对社区老年人跌倒风险的相关因素进行分析,为采取有效的预防和干预措施提供依据。方法:采用"跌倒风险评估量表"对北京市某社区221名老年人进行跌倒风险的评估。结果:该社区老年人跌倒风险评估量表平均得分为(28.12±7.47)分,有跌倒风险的老年人(得分≥30分者)占该人群的43.44%。性别、是否有尿频尿急等情况、是否使用助行器、是否患慢性疾病、是否进行体育锻炼、是否有跌倒史等因素与跌倒风险相关(P<0.05)。结论:该社区老年人跌倒风险较高,应针对跌倒风险的相关因素采取有效的预防和干预措施,并在今后的研究中加大对跌倒风险的评估以预防跌倒的发生。目的:调查北京市某社区老年人跌倒风险现状,并对社区老年人跌倒风险的相关因素进行分析,为采取有效的预防和干预措施提供依据。方法:采用"跌倒风险评估量表"对北京市某社区221名老年人进行跌倒风险的评估。结果:该社区老年人跌倒风险评估量表平均得分为(28.12±7.47)分,有跌倒风险的老年人(得分≥30分者)占该人群的43.44%。性别、是否有尿频尿急等情况、是否使用助行器、是否患慢性疾病、是否进行体育锻炼、是否有跌倒史等因素与跌倒风险相关(P<0.05)。结论:该社区老年人跌倒风险较高,应针对跌倒风险的相关因素采取有效的预防和干预措施,并在今后的研究中加大对跌倒风险的评估以预防跌倒的发生。     

安全文化建设在住院老年患者跌倒中的应用

目的 探索安全文化建设在住院老年患者跌倒管理中的应用与效果.方法 将安全文化建设的报告文化、公平文化、弹性文化和学习文化4方面内容,有效地应用到住院老年患者预防跌倒的护理管理中.结果 跌倒高危预报率增加,跌倒发生率降低,差异均具有统计学意义(P＜0.01或P＜0.05).结论 安全文化建设应用于住院老年患者跌倒的护理管...     

Falls in older people: the role of assessment in prevention and care

Falls among older people constitute a serious public health problem, which has a substantial impact on both the person and on healthcare services. Falls assessment can be divided into a number of types. Community nurses are well placed to use falls risk checklists to identify older people who may be at risk of falling and then offer these individuals a more in-depth assessment. In addition, community nurses have a role to play in assessing older people who have recently fallen to prevent future falls and potential injury. Falls prevention programmes centre on the identification of risk factors and the planning and delivery of interventions designed to eliminate or ameliorate these risks. A falls assessment should include a review of intrinsic factors such as mobility, lower extremity functioning, vision, medications, footwear and past medical history. It is also important to consider extrinsic factors such as tripping, slipping and other environmental hazards.     

A look at the problem of falls among people with cancer

People with cancer often have multiple risk factors for falls. A major risk factor is aging; because people often are diagnosed with cancer at an older age or are living longer with cancer, many are at risk for falls. Additional risk factors include impaired physical function, sensory-neurologic deficits, use of multiple medications, and deconditioning, often caused by treatment-induced fatigue. Of all types of accidents, falls pose the most serious threat to the elderly. Fall injuries can have serious consequences related to reduced physical functioning and quality of life. A detailed understanding and awareness of the risk factors (both intrinsic and extrinsic) and problems associated with falls can assist oncology nurses to be vigilant in the identification of patients at high risk for falls. These patients may benefit from protocols used in other patient populations, new interventions, or the use of assistive devices.     

The social epidemiology of falls among community-dwelling elderly: guidelines for prevention.

Social epidemiology offers a conceptual model that organizes the risk factors for falls into demographic, medical and psychosocial host factors, environmental factors and the agent in falls. Once identified in such a manner it is possible to differentiate between those factors which are or are not amenable to change or treatment, thus suggesting methods of fall prevention. Fall prevention strategies are feasible before a fall, at the time of a fall, and following an injurious fall, corresponding to primary, secondary, and tertiary prevention. At each level of prevention, prevention strategies are described, and together they constitute a complete fall prevention programme for community-dwelling elderly. A review of those strategies that have been evaluated shows that their efficacy in reducing the incidence of falls and their adverse complications is generally limited. Thus, further evaluation research is needed in order to incorporate the most effective fall prevention programmes into standard community care for the elderly.     

231名城市老年人跌倒影响因素的调查

目的探索汕头市某机构老年人跌倒的影响因素,为进一步开展预防老年人跌倒干预措施提供依据。方法于2018年4月由经过培训的工作人员按统一标准对汕头市某机构231名老年人进行跌倒问卷调查和平衡能力测试。结果单因素分析结果表明,与老年人跌倒发生有关的因素有受教育程度、是否害怕跌倒、是否有心脏病、是否服用糖尿病药、是否小便失禁和平衡能力降低(P<0.05)。多因素分析结果表明老年人跌倒的保护因素为受教育程度在大专及以上(OR=0.25,95%CI:0.10-0.63);危险因素包括服用糖尿病药(OR=3.81,95%CI:1.01-14.33)、小便失禁(OR=6.48,95%CI:1.32-31.72)和平衡能力降低(OR=3.50,95%CI:1.71-7.15)。结论服用糖尿病药、小便失禁、平衡能力降低会增加老年人跌倒风险,而较高的受教育程度是保护因素,建议今后根据老年人跌倒影响因素开展有针对性的预防研究。     

Falls in the nursing home: preventable or inevitable?

1. Falls in the elderly are frequent occurrences and are usually a result of the complex interaction of environmental, physiological, and pathological variables. Fall-related injuries happen much less frequently. 2. Physical restraints have not been found effective in preventing falls and may be associated with increased risk of fall-related injury. 3. Because of the complex nature of falls in the elderly, fall prevention programs must emphasize the critical assessment of each resident's risks for falling with targeted interventions.     

老年人跌倒预防措施研究进展

跌倒是一个世界性的公共卫生问题。跌倒的主要人群为老年人,每年因为跌倒,导致众多的公共卫生支出以及对跌倒患者的生活造成严重的损害。本文从发生跌倒的相关因素、老年人跌倒研究的评定方法及测评工具、跌倒的预防措施及老年人跌倒的研究不足等方面,对老年人跌倒预防措施进行综述。     

老年医院预防患者跌倒管理流程建立与应用

目的:通过建立与实施预防患者跌倒管理流程,探讨控制老年住院患者跌倒发生率的有效方法。方法:对病区住院患者实施预防跌倒管理流程,主要内容包括入院评估、签署"预防跌倒告知单"、高危警示标识的应用、针对高危因素采取有效预防措施、强化对患者及家属进行健康教育及不良住院环境的改善等。结果:实施预防患者跌倒管理流程可降低跌倒发生率,有助于建立合作性护患关系,提高患者的依从性,减少了医疗纠纷的发生。     

社区中危以上跌倒风险老年人护理干预效果的评价

目的探讨护理干预在预防社区中危以上跌倒风险老年人跌倒中的应用方法及效果。方法 2015年1-12月,采用便利抽样法选取上海市南码头街道某居委中危以上跌倒风险的老年人100例为研究对象,实施入户跌倒危险因素分析与个性化护理干预措施,采用老年人跌倒风险评估量表、跌倒预防知-信-行问卷及跌倒居家环境危险因素评估表对干预效果进行调查。结果干预后,社区中危以上跌倒风险老年人的跌倒发生率及跌倒风险评分低于干预前、跌倒预防知-信-行评分高于干预前、跌倒环境危险因素评分低于干预前,差异均有统计学意义(均P0.05)。结论个性化的跌倒危险因素分析与护理干预可以提高社区中危以上跌倒风险老年人的跌倒预防知-信-行,减少环境危险因素,有效预防跌倒的发生。     

我国老年人跌倒影响因素研究的可视化分析

目的分析我国近年老年人跌倒影响因素的相关研究,探讨其研究现状及发展趋势,为老年人跌倒预防提供参考依据。方法检索CNKI、万方数据库、VIP和CBM数据库中发表的有关老年人跌倒影响因素的相关文献,检索时间自数据库建库至2018年9月,使用Bicomb 2.0、Ucinet 6.0、Netdraw、gCluto软件进行可视化分析。结果共纳入相关研究432篇,通过影响因素聚类分析得出老年人跌倒的影响因素有生理机能退化、药物相关不良反应以及高龄有跌倒史的女性。通过关键词聚类分析认为该领域的研究热点有以下4类:城市老年人因居家环境、骨质疏松、糖尿病所致的骨折损伤;卒中后老人害怕跌倒、锻炼与其跌倒效能及平衡功能的关系;住院患者跌倒的预防、护理对策及健康教育;对社区、养老机构老年人跌倒的流行病学研究等。结论我国有关老年人跌倒影响因素的相关研究较多,但目前仍缺乏深入的定量分析。有关老年人跌倒影响因素的研究还有待高质量、大数据文献的进一步支持。     

Comprehensive fall prevention programs across settings: a review of the literature

The prevention and management of falls across health care and community settings continues to be one of the greatest challenges in geriatric nursing. This article reviews the literature on fall prevention and management and provides information on national programs and resources, as well as public policy related to falls in the elderly.     

住院老年患者跌倒预防“知-信-行”的调查研究

目的：调查住院老年患者跌倒预防知识、态度、行为的现状,为采取综合性护理干预措施提供科学依据,以降低住院老年患者跌倒发生率。方法：整群抽取我院2012年1-4月住院的老年患者122例作为研究对象,应用自行设计的住院老年患者预防跌倒知识、态度、行为调查问卷进行调查研究。结果：住院老年患者跌倒预防知识问卷得分为（35．40±9．09）分（0～60分）;跌倒预防态度问卷得分为（26．10±4．57）分（0～44分）;跌倒预防行为问卷得分为（27．70±5．02）分（0～48分）。住院老年患者跌倒预防的知识水平与跌倒预防的相关态度呈正相关（r=0．415,P〈0．01）;跌倒预防的知识水平与跌倒预防的相关行为评分无明显相关关系（P〉0．01）;态度与行为评分呈正相关（r=0．387,P〈0．01）。结论：住院老年患者跌倒预防知识缺乏,自我防护意识较弱。护士应加强对住院老年患者跌倒预防知识的健康教育,帮助其建立跌倒预防的健康信念,才能有效地促进跌倒预防健康行为的形成。     

老年人跌倒危险因素评估及护理干预研究进展

随着世界老年人口数量快速增长,老年健康问题引起了空前的关注。跌倒及其相关问题是老年健康问题的重要组成部分。跌倒可引发或加重老年人原有疾病,引起心理创伤,降低其灵活性和独立性,进而减少自主活动,严重影响老年人的生活质量。跌倒已成为老年人伤残、失能和死亡的主要原因之一。本文针对老年人跌倒危险因素的评估及护理干预进行综述,旨在为科学、有效地预防老年人跌倒提供参考和依据。     

Nurses' caring attitude: fall prevention program implementation as an example of its importance

BACKGROUND OF THE PROBLEM. Fall prevention programs are universally multidisciplinary, but nursing care plays the central role. Since October 2008, Medicare has no longer reimbursed acute care hospitals for the costs of additional care required due to hospital‐acquired injuries (e.g., injurious falls). PROBLEM. However, fall prevention programs for hospitalized patients have had limited success, and multifaceted strategies for implementing fall prevention programs cannot guarantee success. It is possible that cultivating and sustaining a caring attitude among clinicians is often overlooked as an intervention strategy. METHOD. This article discusses the barriers to implementing fall prevention programs in acute care hospitals. The attributional theory of success and failure is used to analyze these barriers. In addition, the author discusses whether a lack of knowledge and/or a lack of caring attitude play a role as the underlying barriers to implementing a successful fall prevention program. A patient's story illustrates patients' expectations for the care environment to center on their needs. Possible educational strategies as interventions for fall prevention programs are discussed. FINDINGS. It is suggested that education goals for nurses need to not only promote their professional knowledge and skills in implementing a fall prevention program but also cultivate their caring attitudes.