Aydin Carolyn, Donaldson Nancy, Aronow Harriet Udin, Fridman Moshe, Brown Diane Storer
Author Affiliations: Research Scientist (Drs Aydin and Aronow), Cedars-Sinai Medical Center and Burns & Allen Research Institute; and Director and Coinvestigator (Dr Aydin), Collaborative Alliance for Nursing Outcomes (CALNOC) Data Management Services, Los Angeles, California; Senior Scientist, CALNOC (Drs Donaldson and Brown), San Ramon, California; Clinical Professor (Dr Donaldson), UCSF School of Nursing, San Francisco, California; CALNOC Statistician (Dr Fridman), AMF Consulting, Inc, Los Angeles, California; and Executive Director (Dr Brown), Cost Improvement Strategy, Kaiser Permanente Northern California Region, Oakland, California.
J Nurs Adm. 2015 May;45(5):254-62. doi: 10.1097/NNA.0000000000000195.
Predictive models for falls, injury falls, and restraint prevalence were explored within nursing unit structures and processes of care.
The patient care team is responsible for patient safety, and improving practice models may prevent injuries and improve patient safety.
Using unit-level self-reported data from 215 hospitals, falls, injury falls, and restraint prevalence were modeled with significant covariates as predictors.
Fewer falls/injury falls were predicted by populations with fewer frail and at-risk patients, more unlicensed care hours, and prevention protocol implementation, but not staffing per se, restraint use, or RN expertise. Lower restraint use was predicted by fewer frail patients, shorter length of stay, more RN hours, more certified RNs, and implementation of fall prevention protocols.
In the presence of risk, patient injuries and safety were improved by optimizing staffing skill mix and use of prevention protocols.
在护理单元的结构和护理流程中探索跌倒、受伤跌倒及约束使用率的预测模型。
患者护理团队负责患者安全，改进实践模式可能预防伤害并提高患者安全。
使用来自215家医院的科室层面自我报告数据，将跌倒、受伤跌倒及约束使用率建模，以显著的协变量作为预测因子。
预测显示，体弱和高危患者较少、无执照护理时长更多以及实施预防方案的人群中跌倒/受伤跌倒较少，但与人员配备本身、约束使用或注册护士专业技能无关。预测显示，体弱患者较少、住院时间较短、注册护士时长更多、注册护士认证更多以及实施跌倒预防方案时约束使用较少。
在存在风险的情况下，通过优化人员配备技能组合和使用预防方案可改善患者伤害情况及安全性。
