1 All authors: Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Founders Bldg, Rm 210, Boston, MA 02114.
AJR Am J Roentgenol. 2014 Sep;203(3):620-6. doi: 10.2214/AJR.13.11982.
We implemented an outpatient falls guideline in 2008 in the department of radiology. Here, we describe our multiyear experience.
This was a retrospective study conducted between April 2006 and September 2013 to investigate outpatient falls. The span of the study was divided into eight periods. The incident reporting system was searched for the falls and the fall-related variables.
A total of 327 falls occurred during 5,080,512 radiology examinations (rate, 0.64/10,000 total examinations). The highest rate was in period 6 (0.83/10,000 examinations). The average for periods 1 and 2 is 0.39/10,000 examinations (37 falls/945,427 examinations), and the average for periods 3-6 is 0.77/10,000 examinations (204 falls/2,656,805 examinations). The average rate for periods 7 and 8 is 0.58/10,000 examinations (86 falls/1,478,280 examinations). There was a statistically significant increase in the total number of falls reported between period 2 and period 3 (p = 0.02). There was a statistically significant decrease in outpatient falls between period 6 and period 7 (p = 0.01). The number of falls among patients 60 years old or older was 177 falls/2,180,093 examinations (rate, 0.81/10,000 examinations), and that among patients younger than 60 years was 150 falls/2,900,419 examinations (rate, 0.52/10,000 examinations), with a statistically significant difference (p = 0.007). Although the rate of falls was higher among female patients, there was no statistically significant difference between the sexes (p = 0.18).
The outcome of the outpatient falls guideline was characterized by an increase, a plateau, and a decrease in incident reports. The initial increase may be due to the Hawthorne effect. The plateau may represent the value closest to the true incidence. The decrease may represent the effect of the program.
我们于 2008 年在放射科实施了门诊跌倒指南。在此，我们描述了多年来的经验。
这是一项回顾性研究，于 2006 年 4 月至 2013 年 9 月间对门诊跌倒进行调查。研究期间分为 8 个阶段。通过事件报告系统搜索跌倒和与跌倒相关的变量。
在 5080512 次放射学检查中，共发生 327 例跌倒（发生率为 0.64/10000 次总检查）。发生率最高的是第 6 期（0.83/10000 次检查）。第 1 期和第 2 期的平均值为 0.39/10000 次检查（37 例跌倒/945427 次检查），第 3 期至第 6 期的平均值为 0.77/10000 次检查（204 例跌倒/2656805 次检查）。第 7 期和第 8 期的平均发生率为 0.58/10000 次检查（86 例跌倒/1478280 次检查）。第 2 期和第 3 期报告的跌倒总数有统计学意义的增加（p = 0.02）。第 6 期和第 7 期之间门诊跌倒有统计学意义的下降（p = 0.01）。60 岁或以上患者跌倒 177 例/2180093 次检查（发生率为 0.81/10000 次检查），60 岁以下患者跌倒 150 例/2900419 次检查（发生率为 0.52/10000 次检查），差异有统计学意义（p = 0.007）。尽管女性患者的跌倒率较高，但性别之间无统计学差异（p = 0.18）。
门诊跌倒指南的结果表现为事件报告的增加、平稳和减少。最初的增加可能是由于霍桑效应。平稳期可能代表最接近真实发生率的值。减少可能代表计划的效果。
