Cumbler Ethan U, Simpson Jennifer R, Rosenthal Laura D, Likosky David J
Department of Internal Medicine, University of Colorado, Denver, CO, USA.
Neurohospitalist. 2013 Jul;3(3):135-43. doi: 10.1177/1941874412470665.
In this 2 part series, analysis of the risk stratification tools that are available, definition for the scope of the problem, and potential solutions through a review of the literature are presented. A systematic review was used to identify articles for risk stratification and interventions. Three risk stratification systems are discussed, St Thomas's Risk Assessment Tool in Falling Elderly Inpatients, Morse Fall Scale, and the Hendrich Fall Risk Model. Of these scoring systems, the Hendrich Fall Risk Model is the easiest to use and score. Predominantly, multifactorial interventions are used to prevent patient falls. Education and rehabilitation are common themes in studies with statistically significant results. The second article presents a guide to implementing a quality improvement project around hospital falls. A 10-step approach to Plan-Do-Study-Act (PDSA) cycles is described. Specific examples of problems and analysis are easily applicable to any institution. Furthermore, the sustainability of interventions and targeting new areas for improvement is discussed. Although specific to falls in the hospitalized patient, the goal is to present a stepwise approach which is broadly applicable to other areas requiring quality improvement.
在这个分为两部分的系列文章中，我们将通过文献综述，介绍现有的风险分层工具分析、问题范围的定义以及潜在的解决方案。我们采用系统综述的方法来识别有关风险分层和干预措施的文章。本文讨论了三种风险分层系统，即老年住院患者跌倒的圣托马斯风险评估工具、莫尔斯跌倒量表和亨德里克跌倒风险模型。在这些评分系统中，亨德里克跌倒风险模型最易于使用和评分。主要采用多因素干预措施来预防患者跌倒。教育和康复是具有统计学显著结果的研究中的常见主题。第二篇文章介绍了围绕医院跌倒实施质量改进项目的指南。文中描述了计划 - 实施 - 研究 - 行动（PDSA）循环的10个步骤。问题和分析的具体示例很容易应用于任何机构。此外，还讨论了干预措施的可持续性以及确定新的改进领域。尽管本文具体针对住院患者的跌倒问题，但其目标是提供一种逐步方法，该方法广泛适用于其他需要质量改进的领域。
