护理人员对痴呆老年人跌倒的看法。一项横断面研究。
The nursing staff's opinion of falls among older persons with dementia. a cross-sectional study.
机构信息
Associate professor, Center of Care Research, Department of Health, Care and Nursing, Gjövik University College, 2815 Gjövik, Norway.
Associate Professor, Faculty of Health Sciences, Department of Medicine and Care, Division of Nursing Science, Linköping University, 58183 Linköping, Sweden.
出版信息
BMC Nurs. 2011 Jun 20;10:13. doi: 10.1186/1472-6955-10-13.
UNLABELLED
The aim of this study was to describe the nursing staff's opinion of caring for older persons with dementia with the focus on causes of falls, fall-preventing interventions, routines of documentation and report and the nursing staff's experiences and reactions when fall incidents occur. A further aim was to compare these areas between registered nurses (RNs) and enrolled nurses (ENs) and staff with ≤5 and >5 years of employment in the care units in question.
BACKGROUND
Falls are common among older people and persons with dementia constitute an additional risk group.
METHODS
The study had a cross-sectional design and included nursing staff (n = 63, response rate 66%) working in four special care units for older persons with dementia. Data collection was conducted with a questionnaire consisting of 64 questions.
RESULTS
The respondents reported that the individuals' mental and physical impairment constitute the most frequent causes of falls. The findings also revealed a lack of, or uncertainty about, routines of documentation and reporting fall-risk and fall-preventing interventions. Respondents who had been employed in the care units more than five years reported to a higher degree that colours and material on floors caused falls. RNs considered the residents' autonomy and freedom of movement as a cause of falls to a significantly higher degree than ENs. RNs also reported a significantly longer time than ENs before fall incidents were discovered, and they used conversation and closeness as fall-preventing interventions to a significantly higher degree than ENs.
CONCLUSIONS
Individual factors were the most common causes to falls according to the nursing staff. RNs used closeness and dialog as interventions to a significantly higher degree to prevent falls than ENs. Caring of for older people with dementia consisted of a comprehensive on-going assessment by the nursing staff to balance the residents' autonomy-versus-control to minimise fall-risk. This ethical dilemma should initiate development of feasible routines of systematic risk-assessment, report and documentation.
目的
本研究旨在描述护理人员对痴呆老年人护理的意见，重点关注跌倒的原因、预防跌倒的干预措施、记录和报告的常规，以及护理人员在发生跌倒事件时的经验和反应。进一步的目的是比较注册护士（RN）和注册护士（EN）以及在相关护理单元工作≤5 年和>5 年的护理人员在这些领域的差异。
背景
跌倒在老年人中很常见，痴呆症患者构成了另一个风险群体。
方法
本研究采用横断面设计，包括在四个专门护理老年痴呆症患者的护理单元工作的护理人员（n=63，应答率 66%）。数据收集采用包含 64 个问题的问卷进行。
结果
受访者报告说，个人的心理和身体障碍是最常见的跌倒原因。调查结果还显示，在记录和报告跌倒风险和预防跌倒干预措施方面，缺乏或不确定常规。在护理单元工作超过五年的受访者报告说，地板的颜色和材料更容易导致跌倒。RN 比 EN 更认为居民的自主权和行动自由是跌倒的一个原因。RN 报告说，他们发现跌倒事件的时间比 EN 长，并且他们使用对话和亲近作为预防跌倒的干预措施的程度也明显高于 EN。
结论
根据护理人员的说法，个人因素是跌倒的最常见原因。RN 比 EN 更频繁地使用亲近和对话作为干预措施来预防跌倒。对痴呆症老年人的护理包括护理人员进行全面的持续评估，以平衡居民的自主权与控制，将跌倒风险降到最低。这种伦理困境应该促使制定可行的系统风险评估、报告和记录常规。
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