Lane A J
College of Nursing, University of Cincinnati Medical Center, Ohio, USA.
Orthop Nurs. 1999 Nov-Dec;18(6):37-43.
To evaluate the effectiveness of a Falls Prevention Program (FPP) in reducing patient fall rate and to examine predictors of falls.
A nonrandom, stratified convenience sample of 292 subjects was selected from medical-surgical/critical care patients at a large community hospital system. The sample included 101 patients who fell prior to the FPP, 98 patients who fell after FPP, and 93 patients who did not fall after FPP.
A retrospective, preimplementation/long-term, postimplementation, comparative, descriptive design was used to address differences in patients who fell before and after FPP. Prediction factors associated with incidence of falls were assessed using a sample that included patients who fell and patients who did not fall in 1995. Data were collected about the patients and the fall incidents via a retrospective chart and incident report review.
No decrease in patient fall rate was found between patients who fell before and after implementation of the FPP. Patients tended to fall attempting to get out of the bed, suffering no injury. Model testing of the linear results of patients who fell and patients who did not fall after the implementation of the FPP demonstrated that fall prediction factors included age 60 or over, impaired memory, muscle weakness, and need of ambulatory assistance (Log linear chi-square: 6.048, df 4, p = 0.811 (p > .05).
Identification of patients who exhibit characteristics of the fall prediction model may be useful in reducing falls in medical-surgical/critical care patients. Further testing of the four-factor model with subsequent inclusion of focused interventions may impact the incidence of falls.
评估预防跌倒计划(FPP)在降低患者跌倒率方面的有效性,并研究跌倒的预测因素。
从一家大型社区医院系统的内科/外科/重症监护患者中选取了292名受试者作为非随机分层便利样本。该样本包括101名在FPP实施前跌倒的患者、98名在FPP实施后跌倒的患者以及93名在FPP实施后未跌倒的患者。
采用回顾性、实施前/长期、实施后、比较性、描述性设计,以探讨FPP实施前后跌倒患者的差异。使用一个包含1995年跌倒患者和未跌倒患者的样本,评估与跌倒发生率相关的预测因素。通过回顾病历和事件报告来收集有关患者和跌倒事件的数据。
在FPP实施前后跌倒的患者之间,未发现患者跌倒率有所下降。患者跌倒往往是试图下床,且未造成伤害。对FPP实施后跌倒患者和未跌倒患者的线性结果进行模型测试表明,跌倒预测因素包括60岁及以上、记忆力受损、肌肉无力以及需要步行辅助(对数线性卡方检验:6.048,自由度4,p = 0.811(p > 0.05))。
识别具有跌倒预测模型特征的患者可能有助于减少内科/外科/重症监护患者的跌倒情况。对四因素模型进行进一步测试,并随后纳入针对性干预措施,可能会影响跌倒发生率。