老年住院患者跌倒管理难点的质性研究及对策分析  

The qualitative research and countermeasure analysis on the management problems of accidental falls in elderly patients

作　　者：赵敏 蒋红 李曙光 苏晓霞 Zhao Min;Jiang Hong;Li Shuguang;Su Xiaoxia(School of Nursing,Fudan University,Shanghai 200032,China;Department of Nursing,Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学护理学院,上海200032 [2]复旦大学附属华山医院护理部,上海200040

出　　处：《中国实用护理杂志》2020年第5期321-326,共6页Chinese Journal of Practical Nursing

基　　金：上海市卫生计生系统重要薄弱学科建设项目(2015ZB0301);复旦大学-复星护理科研基金(FNF201806)。

摘　　要：目的探讨护理管理者在老年住院患者跌倒不良事件管理过程中所遇到的主要问题与难点。方法采用目的抽样法选取上海市综合性医院的10名护理管理者进行半结构式深度访谈,并通过Colaizzi内容分析法进行访谈内容分析。结果本研究共提炼出7个主题:老年患者主动预防跌倒意识淡薄;主要照护者安全陪护能力欠缺;临床护士执行干预措施未细致精准;多部门管控未完全协调一致;医院环境适老化与无障碍理念不足;跌倒相关技术产品未引入与普及;缺乏医疗政策的支持与专项资金的投入。结论适当增设跌倒课程与培训计划,提高医务人员跌倒知识与技能水平,积极改变健康宣教方式与内容,增强老年患者与主要照护者风险意识及陪护能力。整合各类医疗资源,建立多学科协作模式共同解决跌倒问题,还应寻求卫生部门对于医疗政策与资金的支持,努力提升无障碍与适老化理念以整体改善住院环境,从而保证患者的安全。Objective To explore the main problems and difficulties encountered by nursing managers in the management of elderly patients with accidental falls.Methods A semi-structured in-depth interview was conducted with ten nursing managers in charge of adverse events,and data was analyzed by Colaizzi analysis.Results Seven themes were extracted from the data,including lack of active awareness of falls prevention,inadequate ability of safety support,lack of precise implementation of interventions,uncoordinated multi-sectoral control,inadequate concepts of ageing and accessibility,lack of related technology products and lack of policy and financial support.Conclusions Fall courses and training programs should be added to improve the level of knowledge and skills of medical staff,and increase the risk awareness and companionship for older and caregivers.And a multidisciplinary team should be formed to conduct a multi-factor intervention on falls.Meanwhile,the concept of barrier-free and ageing to improve the hospital environment will be advocated under the supports of the government to formulate medical policies and increase capital investment.

关 键 词：老年人 意外跌倒 住院患者 质性研究 护理管理 

分 类 号：R47[医药卫生—护理学]