- 作者：Zenewton A.S. Gama ; Francesc Medina-Mirapeix ; Pedro J. Saturno
- 关键词：Quality improvement ; falls prevention ; nursing homes
- 刊名：Journal of the American Medical Directors Association
- 出版年：2011
- 出版时间：July 2011
- 年：2011
- 卷：12
- 期：6
- 页码：398-402
- 全文大小：138 K
Objective
To evaluate the effectiveness of an ad hoc multifaceted program to improve structure, professional behavior, and outcomes related to falls prevention.Design
Internal quality improvement cycle.
Setting
Nursing home in Spain.
Participants
An institution with 130 residents.
Intervention
Local building of quality criteria, audit and feedback, and a specific intervention to improve based on educational and sensitization activities and changes in the process and recording systems.
Measurement
Quality of falls prevention was assessed using reliable evidence-based criteria (4 of structure and 9 of process), at baseline and 6 months after a specific intervention to improve. Number of falls was recorded in a random sample (n = 60) of residents (≥65 years) during a 1-year follow-up and summarized fortnightly as an indicator analyzed using a statistical control chart.
Results
Baseline structure and fall prevention practices were poor. After the intervention, all structure criteria were present and 8 of 9 process criteria improved significantly. Thirty-two falls occurred 6 months before and 21 after the intervention started, showing a significant decrease in the fortnightly incidence (P < .01).
Conclusions
Adherence to evidence-based recommendations was poor in our setting, but the internal quality improvement cycle was useful in ensuring safe practices and in achieving better outcomes.