University of NC at Charlotte School of Nursing, Charlotte, North Carolina, USA.
J Patient Saf. 2013 Mar;9(1):29-35. doi: 10.1097/PTS.0b013e3182753e4f.
Patient falls are a challenging safety and quality issue in acute care settings. This study compared inpatient falls on medical-surgical units with and without Webcams and assessed the Morse Risk Assessment (MRA) for effectiveness in identifying fall risk.
Ten hospitals in one health system that exceeded the benchmark for falls were chosen for a 6-month study. One medical-surgical unit in each of the 10 hospitals was randomly assigned to an intervention or control group. The intervention group used Webcams that viewed the bed with a central monitoring system. A "virtual bed rail" function was used for those patients with a Morse Risk Assessment (MRA) of greater than 25.
Consent rate was 20.7% for the intervention group. A significant difference (P ≤ 0.05) between groups was found in fall rate per 1000 admissions, but no significant difference was found in fall rate per 1000 patient days. The Morse Risk Assessment was a significant predictor of risk.
Webcams are one option to increase surveillance for high-risk patients. The use of the MRA with a 50+ score for high risk is recommended. More research is needed on patient acceptance of this form of intervention and effectiveness in preventing falls on various inpatient units or with specific age groups.
患者跌倒在急性护理环境中是一个具有挑战性的安全和质量问题。本研究比较了有和没有网络摄像头的内科-外科病房的住院患者跌倒情况,并评估了 Morse 风险评估(MRA)在识别跌倒风险方面的有效性。
选择一家医疗系统中超过跌倒基准的 10 家医院进行为期 6 个月的研究。这 10 家医院中的每一家都随机将一个内科-外科病房分配到干预组或对照组。干预组使用网络摄像头,通过中央监控系统查看病床。对于 Morse 风险评估(MRA)大于 25 的患者,使用“虚拟床栏”功能。
干预组的同意率为 20.7%。组间在每千例入院患者的跌倒率(P ≤ 0.05)方面存在显著差异,但在每千例患者住院天数的跌倒率方面没有显著差异。Morse 风险评估是风险的显著预测因素。
网络摄像头是增加高危患者监测的一种选择。建议对高风险患者使用 MRA 评分 50+。需要对这种干预形式的患者接受度及其在预防各种住院病房或特定年龄组跌倒方面的有效性进行更多研究。