老年急性护理（ACE）病房能否降低跌倒发生率？

Does acute care for the elderly (ACE) unit decrease the incidence of falls?

作者信息

Abdalla Ahmed, Adhaduk Mehul, Haddad Raad A, Alnimer Yanal, Ríos-Bedoya Carlos F, Bachuwa Ghassan

机构信息

Internal Medicine Residency Program, Hurley Medical Center, Michigan State University, 1 Hurley Plaza, Flint, MI 48503, USA.

出版信息

Geriatr Nurs. 2018 May-Jun;39(3):292-295. doi: 10.1016/j.gerinurse.2017.10.011. Epub 2017 Nov 11.

DOI:10.1016/j.gerinurse.2017.10.011

PMID:29137820

Abstract

To determine whether acute care for the elderly (ACE) units decrease the incidence of patient falls compared to general medical and surgical (GMS) units, a non-concurrent prospective study included individuals aged 65 and older admitted to ACE or GMS units over a 2-year span was done. There were 7069 admissions corresponded to 28,401 patient-days. A total of 149 falls were reported for an overall incidence rate (IR) of 5.2 falls per 1000 patient-days, 95% CI, 4.4/1000-6.1/1000 patient-days. The falls IR ratio for patients in ACE unit compared to those in non-ACE units after adjusting for age, sex, prescribed psychotropics and hypnotics, and Morse Fall Score was 0.27/1000 patient-days; 95% CI, 0.13-0.54; p < 0.001. So, an estimated 73% reduction in patient falls between ACE unit and non-ACE units. Hospitals may consider investing in ACE units to decrease the risk of falls and the associated medical and financial costs.

摘要

为了确定与普通内科和外科（GMS）病房相比，老年急性护理（ACE）病房是否能降低患者跌倒的发生率，我们进行了一项非同期前瞻性研究，纳入了在两年时间内入住ACE或GMS病房的65岁及以上的患者。共有7069例入院病例，相当于28401个患者住院日。共报告了149次跌倒，总体发生率（IR）为每1000个患者住院日5.2次跌倒，95%置信区间为每1000个患者住院日4.4 - 6.1次跌倒。在调整年龄、性别、处方精神药物和催眠药物以及莫尔斯跌倒评分后，ACE病房患者与非ACE病房患者的跌倒发生率比值为每1000个患者住院日0.27次；95%置信区间为0.13 - 0.54；p < 0.001。因此，估计ACE病房和非ACE病房之间患者跌倒发生率降低了73%。医院可考虑投资建设ACE病房，以降低跌倒风险以及相关的医疗和财务成本。