運用跨團隊合作降低神經內科住院病人跌倒發生率之改善專案

An Improvement Project with Interdisciplinary Team Collaboration to Reduce Fall Incidents Among Inpatients in Neurological

劉錦茹(Chin-Ju Liu)；邱品媜(Pin-Chen Chiu)；鄭雪梅(Hsueh-Mei Cheng)

跨團隊合作 ； 住院病人跌倒 ； 衰弱評估 ； fragility assessment ； inpatient falls ； interdisciplinary team collaboration

志為護理-慈濟護理雜誌

20卷1期（2021 / 02 / 01）

134 - 144

繁體中文

醫院常見跌倒事件導致重度傷害，其增加醫療成本與照護負荷。本單位神經內科病人跌倒發生率0.25％及重傷害事件發生率6.1％，故本專案目的為運用跨團隊合作降低跌倒發生率，經現況分析問題為病人或照護者對於防跌衛教內容不清楚或未接受相關衛教內容、意識障礙病人無法配合會自行下床、照護者短暫離開未告知護理師、護理人員未接受下肢肌力運動課程、未給予病人或照護者預防跌倒衛教單等。並擬定解決對策為修改預防跌倒衞教單並結合QR Code功能、預防跌倒影片、衰弱評估表供跨團隊合作啟動機制、防跌安全防護網及三安卡等。專案改善前後跌倒發生率由0.25％降為0.08％，效果維持期為0.08％，達到有效降低跌倒發生率。

Fall incidents in hospitals commonly result in severe injuries, thus increasing the medical costs and care burden. The incidence rates of falls and severe injuries in our Neurological Department were 0.25% and 6.1%, respectively. The purpose of this project is to reduce the fall incidents through an interdisciplinary team collaboration. The analysis of problem indicated that the following aspects contribute to fall incidents: missing or unclear fall prevention information or poor accessibility to patient education materials among patients or caregivers, limited capacities of unconscious patients, temporary absence of caregivers without any advance notice to the healthcare professionals, and the lack of lower extremity strengthening exercise programs. The corresponding resolving strategies were proposed: modifying the contents of fall prevention patient education materials with QR codes, establishing fall prevention videos, developing a fragility assessment scale for the interdisciplinary team to initiate and share information, building a fall prevention safety network, and creating a triple-secured card. As compared with the baseline, the incidence of fall reduced from 0.25% to 0.08% after the implementation of the project, and remained at 0.08% during the maintenance stage, thereby suggesting that such project effectively reduced the fall incidents.

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