降低高齡整合醫學病房住院病人跌倒之發生率

Reducing the Incidence of Falls in Elderly Patients in Geriatrics Medical Wards

10.6540/NTJN.202209_24(2).0006

謝佳珉(Chia-Min Hsieh)；呂宜錦(Yi-Chin Lu)；陳郁琪(Yu-Chi Chen)；林靖芸(Jing-Yun Lin)；許夢萍(Meng-Ping Hsu)

高齡 ； 住院病人 ； 跌倒發生率 ； Geriatrics ； hospitalized patients ； fall rate

新臺北護理期刊

24卷2期（2022 / 09 / 01）

58 - 70

繁體中文

病人安全通報系統顯示跌倒事件為通報第二名，故降低跌倒發生是重要的課題。查檢發現：病人肌力不足及平衡感差、照顧者輪替、病人及照顧者對預防跌倒認知不足、護理師未在輪替時，再次執行衛教、缺少復健設備及行走輔助器、衛教方式不一致、病人從床縫溜下及照顧者非本國籍等，皆造成高齡整合醫學病房住院病人跌倒之發生率高，引發專案動機，擬定方案包括：拍攝多語言情境影片、增建復健設備及行走輔助器、建構LINE Bot推播、訂定跨領域討論會、訂定品管稽核、創新製作床縫網套。經措施執行後，護理人員執行預防跌倒作業正確率提升至98%、跌倒高危險群照顧者認知問卷分數提升至90分，住院病人跌倒發生率下降至0%。

According to the Taiwan Patient-safety Reporting system (TPR), falls are the second most frequently reported events among patients. For this reason, it is important to reduce the occurrence of fall events. Results from an inquiry indicated several factors, such as the patients' lack of muscle strength and poor balance, caregiver shift schedules, poor perceptions among patients and caregivers toward fall prevention, nurses' failure to provide instruction during handovers, the lack of rehabilitation equipment and walking aids, dissimilar health education approaches, patients sliding off a bed, and foreign caregivers, contributing to the high rate of falls among elderly hospitalized patients in an integrated geriatric ward. Several proposals were developed to redress these issues, which included producing multilingual scenario-based videos, increasing the availability of rehabilitation equipment and walking aids, setting up notifications through a LINE app promotion, organizing multidisciplinary team meetings, performing quality audits, and making innovative foam bolster mattress covers. Following the implementation of the aforementioned measures, nurses' accuracy in performing fall prevention measures increased to 98%, caregivers' questionnaire scores regarding the perception of high-risk groups increased to 90 points, and the fall rate of hospitalized patients decreased to 0%.

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