某三级医院神经外科患者跌倒坠床风险及对策分析
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摘要
目的探讨温州市某三甲综合医院神经外科患者跌倒坠床风险现状并分析对策。方法 2016年3月至2017年3月温州市某三级甲等综合医院神经外科对280名术后患者采用自行编制的调查问卷进行测量,主要评估手术后患者跌倒坠床风险评分状况。结果 280名神经外科术后患者跌倒坠床评分为45.52±12.87分,处于较高跌倒风险水平,考虑可能的高风险因素有患者的年龄、跌倒次数、精神认知、头晕程度、排泄改变、视力情况、特殊用药、虚弱乏力、起立测试、步态平衡、依从性及实验室检查。结论不同因素对患者所产生的跌倒风险影响不同,需要临床工作者针对不同患者在入院时进行跌倒风险评估,分析可能会引起患者跌倒的因素,更好地控制跌倒的发生,保证患者住院期间的安全。
Objective To investigate the status of risk factors of falls in neurosurgery patients and to explore countermeasures in a tertiary hospital in Wenzhou, Zhejiang Province. Methods A total of 280 patients admitted to neurosurgery department of a Class-A tertiary hospital in Wenzhou from March 2016 to March 2017 were investigated with a self-developed questionnaire after surgery. The questionnaire was mainly measuring the risk score of falls for postoperative patients in neurosurgery. Results Among the 280 patients recruited,the average fall risk score was 45.52±12.87,which was in a high level. Possible high risk factors were age, fall times, degree of cognition, dizziness, excretion, eyesight, special medicine, weakness, Timed Up and Go Test, walking balance, compliance and laboratory test, etc. Conclusion Different factors cause different degrees of risk. Clinicians are supposed to conduct a detailed assessment of the risk of falls during admission for different patients, to analyze the potential risk factors, in order to better control the incidence of falls, and to ensure the safety of patients during hospitalization.
Objective To investigate the status of risk factors of falls in neurosurgery patients and to explore countermeasures in a tertiary hospital in Wenzhou, Zhejiang Province. Methods A total of 280 patients admitted to neurosurgery department of a Class-A tertiary hospital in Wenzhou from March 2016 to March 2017 were investigated with a self-developed questionnaire after surgery. The questionnaire was mainly measuring the risk score of falls for postoperative patients in neurosurgery. Results Among the 280 patients recruited,the average fall risk score was 45.52±12.87,which was in a high level. Possible high risk factors were age, fall times, degree of cognition, dizziness, excretion, eyesight, special medicine, weakness, Timed Up and Go Test, walking balance, compliance and laboratory test, etc. Conclusion Different factors cause different degrees of risk. Clinicians are supposed to conduct a detailed assessment of the risk of falls during admission for different patients, to analyze the potential risk factors, in order to better control the incidence of falls, and to ensure the safety of patients during hospitalization.
引文
1北京协和医院世界卫生组织分类合作中心翻译组.疾病和有关健康问题的国际统计分类(ICD-10)第10版[M].北京:人民卫生出版社,1996:839-841
2 Oliver D,Connelly JB,Victor CR,et a1.Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment:Systematic review and meta-analyses[J].BMJ,2007,334(7584):82-87
3 陆明凤,李文娟.预防跌倒/坠床管理流程在神经外科病房的应用[J]医院管理论坛,2013,30(8):15-17
4 Masud T,Morris RO.Epidemiology of falls[J].Age Ageing,2001,30(4):3-7
5 徐赛珠,徐珊瑚,金煜,等.不同跌倒风险评估方法在老年住院病人中的应用研究[J].医院管理论坛,2017,34(8):20-22
6 刘水桂,石立红,季苏萍.失效模式与效应分析预防住院患者跌倒的实践与探讨[J].医院管理论坛,2017,34(6):15-17
7 Mahoney JE,Palta M,Johnson J,et al.Temporal association between hospitalization and rate of fails after discharge[J].Arch intern Med,2000,160(18):2788-2795
8 AGS/BGS.Clinical practice guideline:Prevention of falls in older persons[EB/OL].[2013-09-25].http://www.American geriatrics.org/health care professionals/clinical practice/clinical guidelines recommendations/prevention of falls summary of recommendations
2 Oliver D,Connelly JB,Victor CR,et a1.Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment:Systematic review and meta-analyses[J].BMJ,2007,334(7584):82-87
3 陆明凤,李文娟.预防跌倒/坠床管理流程在神经外科病房的应用[J]医院管理论坛,2013,30(8):15-17
4 Masud T,Morris RO.Epidemiology of falls[J].Age Ageing,2001,30(4):3-7
5 徐赛珠,徐珊瑚,金煜,等.不同跌倒风险评估方法在老年住院病人中的应用研究[J].医院管理论坛,2017,34(8):20-22
6 刘水桂,石立红,季苏萍.失效模式与效应分析预防住院患者跌倒的实践与探讨[J].医院管理论坛,2017,34(6):15-17
7 Mahoney JE,Palta M,Johnson J,et al.Temporal association between hospitalization and rate of fails after discharge[J].Arch intern Med,2000,160(18):2788-2795
8 AGS/BGS.Clinical practice guideline:Prevention of falls in older persons[EB/OL].[2013-09-25].http://www.American geriatrics.org/health care professionals/clinical practice/clinical guidelines recommendations/prevention of falls summary of recommendations