Albornos-Muñoz Laura, Melián-Correa Esther, Acosta-Arrocha Amanda, Gallo-Blanco Carmen, Béjar-Bacas Felicidad, Alonso-Poncelas Emma, Serra-Estrada Montserrat, González-María Esther, Moreno-Casbas María Teresa
The Spanish Centre for Evidence Based Nursing and Healthcare: a Joanna Briggs Institute Centre of Excellence.
Hospital Doctor José Molina Orosa, Servicio Canario de Salud, Islas Canarias, Spain.
JBI Database System Rev Implement Rep. 2018 Jan;16(1):247-257. doi: 10.11124/JBISRIR-2017-003349.
The current project aimed to improve fall prevention and management through clinical audits and the implementation of a quality-improvement cycle at the local level.
Falls are one of the most common adverse events reported in hospitals; evidence-based fall prevention interventions aim to reduce the number of people who fall.
A one-year clinical audit was conducted using a pre-post implementation audit method, namely the Joanna Briggs Institute's (JBI) Practical Application of Clinical Evidence System and the getting research into practice audit and feedback tool. Two medical wards and a surgical ward in a Spanish hospital participated. The subjects were evaluated at baseline and at a follow-up at six months after key strategies had been implemented.
Compliance rates for the evidence-based criteria were low in the baseline audit. Five barriers were identified in relation to fall assessment and management and, based on getting research into practice, strategies were designed, developed and implemented to overcome these barriers. After implementation, most of the fall-risk-assessment criteria showed an overall improvement, but there was no effect on care plan recording. Awareness of the assessment and management of fall risks were increased among professionals and patients on all three study wards.
The current project may improve compliance with regard to promoting evidence-based fall prevention and management interventions. Further audits are necessary to evaluate any improvements achieved, in particular, care plans.
当前项目旨在通过临床审计以及在地方层面实施质量改进循环来改善跌倒预防与管理。
跌倒是医院报告的最常见不良事件之一；基于证据的跌倒预防干预措施旨在减少跌倒人数。
采用实施前后审计方法进行了为期一年的临床审计，即乔安娜·布里格斯研究所（JBI）的临床证据系统实际应用以及将研究成果应用于实践的审计与反馈工具。西班牙一家医院的两个内科病房和一个外科病房参与其中。在关键策略实施后的基线期和六个月随访期对受试者进行评估。
基线审计中基于证据的标准合规率较低。在跌倒评估与管理方面确定了五个障碍，并根据将研究成果应用于实践的原则，设计、制定并实施了克服这些障碍的策略。实施后，大多数跌倒风险评估标准总体有所改善，但对护理计划记录没有影响。所有三个研究病房的专业人员和患者对跌倒风险评估与管理的认识均有所提高。
当前项目可能会提高在促进基于证据的跌倒预防和管理干预措施方面的合规性。有必要进行进一步审计以评估所取得的任何改进，特别是护理计划方面的改进。
