基于护理敏感性结局指标构建持续监控体系在老年住院患者跌倒预防中的效果  

Effects of establishing a continuous monitoring system based on nursing sensitivity outcome indexes on fall prevention in elderly inpatients

作　　者：黄巧[1] 卢少萍[2] 许智红[3] 徐永能[1] 任晓晓[4] 赵雪琴[1] 马慧欣 Huang Qiao;Lu Shaoping;Xu Zhihong;Xu Yongneng;Ren Xiaoxiao;Zhao Xueqin;Ma Huixin(Comprehensive Ward,Guangdong Academy of Medical Sciences,Guangdong Provincial People's Hospital,Guangdong Institute of Geriatrics,Guangzhou 510080,China;Department of Nursing,Guangdong Academy of Medical Sciences,Guangdong Provincial People's Hospital,Guangzhou 510080,China;Office,Guangdong Academy of Medical Sciences,Guangdong Provincial People's Hospital,Guangdong Institute of Geriatrics,Guangzhou 510080,China;Department of Traditional Chinese Medicine,Guangdong Academy of Medical Sciences,Guangdong Provincial People's Hospital,Guangdong Institute of Geriatrics,Guangzhou 510080,China)

机构地区：[1]广东省医学科学院广东省人民医院广东省老年医学研究所综合病区,广州510080 [2]广东省医学科学院广东省人民医院护理部,广州510080 [3]广东省医学科学院广东省人民医院广东省老年医学研究所办公室,广州510080 [4]广东省医学科学院广东省人民医院广东省老年医学研究所中医科,广州510080

出　　处：《中华现代护理杂志》2020年第32期4456-4461,共6页Chinese Journal of Modern Nursing

基　　金：广东省医学科研基金项目(A2015459)。

摘　　要：目的构建基于护理敏感性结局指标的持续监控体系,以提高老年住院患者跌倒预防的质量。方法采用便利抽样的方法,选取2016年4月-2017年1月广东省人民医院老年医学研究所14个病房的老年住院患者及其照顾者为研究对象,同时将14个病房的护士纳入研究。随机将7个病房作为对照组,7个病房作为试验组。试验组患者151例,照顾者137名,护士68名;对照组患者151例,照顾者131名,护士57名。对照组采用护理部质控科-科护士长-病区护士长的常规三级监控方法进行跌倒预防质量监控,试验组在此基础上应用老年住院患者跌倒相关评价量表对跌倒的预防质量进行持续自我监控。采用跌倒效能量表(MFES)比较两组患者跌倒效能评分和住院期间跌倒的发生率,采用照顾者跌倒知信行量表比较两组患者照顾者干预前后防跌倒知信行情况,采用一般自我效能量表比较两组护士自我效能情况。采用老年住院患者跌倒相关评价量表比较试验组患者干预前后跌倒预防质量评价结果。结果试验组患者住院期间无一例发生跌倒,对照组患者发生跌倒2例,两组患者跌倒发生率比较差异无统计学意义(P>0.05)。试验组患者出院时跌倒效能评分(70.77±16.85)分,对照组(62.77±18.78)分,差异有统计学意义(t=3.179,P<0.01)。干预后试验组照顾者跌倒知信行得分高于对照组,护士自我效能得分高于对照组,差异均有统计学意义(P<0.01)。试验组干预后预防跌倒质量评分高于干预前,差异有统计学意义(P<0.05)。结论基于护理敏感性结局指标构建的持续监控体系,能够提升老年患者的跌倒预防质量及跌倒效能,提高照顾者跌倒预防的知识、态度和行为以及护士的自我效能感。Objective To establish a continuous monitoring system based on nursing sensitivity outcome indexes so as to improve the quality of fall prevention in elderly inpatients.Methods By adopting the convenient sampling method,the elderly inpatients and their caregivers in 14 wards of the Institute of Geriatrics of Guangdong People's Hospital from April 2016 to January 2017 were selected as the research objects,and the nurses in 14 wards were also included in the research.A total of 14 wards were randomly divided into the control group with 7 wards and the experimental group with 7 wards.In the experimental group,there were 151 patients,137 caregivers and 68 nurses.In the control group,there were 151 patients,131 caregivers and 57 nurses.In the control group,the quality of fall prevention was monitored by the conventional three-level monitoring method of quality control department of the nursing department,head nurse of department and head nurse of ward.On this basis,the experimental group applied Fall-related Evaluation Scale for Elderly Inpatients to continuously monitor the quality of fall prevention.Modified Fall Efficacy Scale(MFES)was used to compare the fall performance scores and the incidence of falls during hospitalization between the two groups.Caregivers'Fall Knowledge,Attitude and Practice Scale was used to compare the knowledge,belief,attitude and practice of caregivers in the two groups before and after intervention.The General Self-Efficacy Scale was used to compare the self-efficacy of nurses in the two groups.The Fall-Related Evaluation Scale for Elderly Inpatients was used to compare the quality evaluation results of fall prevention before and after intervention in the experimental group.Results None of the patients in the experimental group fell during their hospitalization,and 2 patients in the control group fell.There was no statistically significant difference in the incidence of falls between the two groups(P>0.05).The fall efficacy score at discharge was(70.77±16.85)in the experimental group an

关 键 词：老年人 护理敏感性结局指标 老年住院患者 监控体系 跌倒预防 

分 类 号：R473[医药卫生—护理学]