運用團隊合作降低神經內外科病房跌倒發生率

Application of Multidisciplinary Cooperation to Reduce Fall Incidence in Neurological Internal and Surgical Wards

10.6142/VGHN.33.1.32

黃麗靜(Li-Ching Huang)；許美玲(Mei-Ling Hsu)；袁雅怡(Ya-Yi Yuan)；郭碧慧(Pi-Hui Kuo)

團隊合作 ； 神經內外科 ； 跌倒 ； multidisciplinary cooperation ； neurological surgical and medical ； falls

榮總護理

33卷1期（2016 / 03 / 01）

32 - 40

繁體中文

神經內外科病人多為跌倒高危險群，本專案目的在透過團隊合作降低跌倒發生率，經由現況分析跌倒發生率高的原因為：預防跌倒護理指導不符使用、病人缺乏病識感、病人意識混亂、缺乏警訊機制及家屬對預防跌倒認知不足。經文獻查證及小組討論後，擬定解決對策：製作預防跌倒衞教資料、運用跨團隊合作，研發「防跌警訊安全防護帶」及播放預防跌倒錄音帶等措施，跌倒發生率由0.14%降為0.09%；建議可平行推廣至同性質之病房單位、居家場所及醫療機構，藉由跨領域的團隊合作，降低跌倒發生率，促進病人安全。

Purpose: Falls are common and should be prevented in neurological internal and surgical wards; the mean incidence of falls in these wards was 0.14% in 2012, significantly higher than that in other wards. This project primarily aimed to reduce the incidence of falls through interdisciplinary cooperation strategies. Methods: Four main strategies of fall prevention were applied, (a) Development-specifi c educational program of fall prevention for neurological patients and caregivers, comprising fall assessment fl owsheets, fall prevention acts during hospitalization, and patient safety related to fall injury. (b) A holistic and individualized care plan for supporting high-fall-risk patients, requiring a multidisciplinary team of a nurse, physician, rehabilitation therapist, and nutritionist. A series of daily activities, namely muscle training, gait stability exercise, a nutrition supplement plan, bedside movement, and nursing education were administered to patients. (c) A safety bed-belt was created to alert caregivers to patient needs. This alert device can help caregivers to check and provide necessary assistance to patients when the patients leave their beds. (d) Information on fall prevention was broadcasted for patients and their families to increase their knowledge of this topic. Results: Falls were defi ned as tumbles without resultant lesions. The average incidence of falls decreased from 0.14% to 0.09% from January to June, 2013. Conclusion: Specifi c educational programs, multidisciplinary care plans for fall prevention, safety bed-belts, and broadcasting fall prevention-related information reduced the incidence of falls and severity of fall injuries.

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