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儿科跌倒:预防措施的效果及儿科病房的特点

Pediatric falls: effect of prevention measures and characteristics of pediatric wards.

作者信息

Fujita Yuichi, Fujita Mayuko, Fujiwara Chieko

机构信息

Department of Nursing, School of Nursing, Hyogo University of Health Sciences, Kobe.

出版信息

Jpn J Nurs Sci. 2013 Dec;10(2):223-31. doi: 10.1111/jjns.12004. Epub 2013 Jan 25.

Abstract

AIM

This study aimed to identify the effect of fall prevention measures and characteristics of wards on the rate of pediatric falls.

METHODS

Data on study variables were collected using a cross-sectional design and questionnaires of 603 randomized general hospitals in Japan. Among the hospitals that were contacted, 252 (41.8%) returned their questionnaires. The questionnaires included the annual number of falls, whether fall prevention measures were implemented, and characteristics of the wards. Data were analyzed from questionnaires from 162 of the hospitals, which included those that answered the number of falls.

RESULTS

The pediatric fall rate was 1.36/1000 patient-days. Facilities were more likely to have a lower fall rate if they had a longer "length of stay" (P < 0.001), "shared information in high-risk patients and monitored them carefully" (P < 0.001), had higher totals for the "number of study sessions for novice nurses" (P = 0.01),and "used a pamphlet to educate patients and caregivers regarding appropriate use of side rails" (P < 0.001). Facilities that had a "playroom" (P < 0.001), higher "novice nurse-to-nurse ratio" (P < 0.001), and those at which "caregivers were necessary for hospitalization" (P = 0.04) were more likely to have a higher fall rate.

CONCLUSION

The results of the present study suggest that education of parents and novice nurses on fall prevention is the most effective method of reducing pediatric falls. It is important to implement intensive fall prevention for high-risk patients and develop valid pediatric fall risk assessment tools.

摘要

目的

本研究旨在确定预防跌倒措施及病房特征对儿科跌倒发生率的影响。

方法

采用横断面设计,通过对日本603家随机选取的综合医院进行问卷调查来收集研究变量的数据。在被联系的医院中,252家(41.8%)返回了问卷。问卷包括每年的跌倒次数、是否实施了预防跌倒措施以及病房的特征。对162家医院的问卷数据进行了分析,其中包括那些回答了跌倒次数的医院。

结果

儿科跌倒发生率为1.36/1000患者日。如果设施的“住院时间”更长(P<0.001)、“在高危患者中共享信息并对其进行仔细监测”(P<0.001)、“新手护士学习课程总数”更高(P=0.01)以及“使用宣传册对患者和护理人员进行关于正确使用床栏的教育”(P<0.001),则其跌倒发生率更有可能较低。设有“游戏室”的设施(P<0.001)、“新手护士与护士比例”更高的设施(P<0.001)以及“住院需要护理人员”的设施(P=0.04),其跌倒发生率更有可能较高。

结论

本研究结果表明,对家长和新手护士进行预防跌倒教育是降低儿科跌倒发生率的最有效方法。对高危患者实施强化预防跌倒措施并开发有效的儿科跌倒风险评估工具非常重要。

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