提升胃腸科病房離床報知機使用遵從率專案

A Project of Increasing Bed-exit Alarm Use in a Gastroenterology Ward

10.6692/KJN-2017-34-2-4

林湘玉(Hsiang-Yu Lin)；林小玲(Shir-Ling Lin)；溫明寰(Ming-Huan Wen)

離床報知機 ； 預防跌倒 ； bed-exit alarms ； fall prevention

高雄護理雜誌

34卷2期（2017 / 08 / 01）

40 - 51

繁體中文

某胃腸科病房2012年之離床報知機使用遵從率僅22.2%，分析導因為：離床報知機相關在職教育不普及，導致臨床人員敏感性低，無法及時警覺架設儀器的時機；缺乏離床報知機作業標準；警示頻繁造成負向使用經驗。解決辦法為舉辦在職教育訓練、配合實證多面向防跌措施並制定離床報知機的標準作業規範、稽核辦法與使用紀錄表、製作離床報知機簡易操作小卡、危險因子適用族群的提醒海報與使用現況分佈板。專案實施後，離床報知機使用遵從率由22.2%提升至64.0%，跌倒發生率由0.15%降至0.12%，追蹤一年的效果維持於0.09%。透過實證文獻查證制定作業規範，針對適合族群提供警示器強化臨床人員的照護，降低住院病人跌倒發生率及傷害率。

The main cause for the high incidence of falls was due to low compliance of bed-exit alarm use (22.2%) in 2012. After serial questionnaire survey, the reasons for low compliance of bed-exit alarms use included unpopularity of in-service education, low sensitivity from clinical nurses, inability to be on guard for the timing of setting device, lack of standard operation procedure, and negative experience from frequent and false alarms. The project aimed to increase compliance of bed-exit alarm use from 22.2% to 64.0% and decrease the incidence of falls from 0.15% to 0.12%. The strategies of this project included in-service education arrangement, evidence-based multidisciplinary approach of falls prevention, establishment of a standard operation procedure, internal audit and records for bed-exit alarm, and preparation of an operation manual, posters for reminding staff of specific sets of risk factors and a billboard of usage status. The compliance of bed-exit alarm use increased to 64.0% and the incidence of falls decreased to 0.12% after the project was conducted. The effect of 1-year maintenance further decreased the incidence of falls to 0.09%. The project established standard operation procedure for bed-exit alarm use and enhanced clinical care by use of the device for suitable populations. This not only decreased the incidence of falls of hospitalized patients but also improved the quality of nursing care.